The effect of time delay on infection in open long-bone fractures: a 5-year prospective audit from a district general hospital.

OBJECTIVES To determine whether a time delay of greater than 6 h from injury to surgical debridement affected the infection rate in open long-bone fractures in a typical district general hospital in the UK. DESIGN Prospective audit over 5 years. METHODS 142 open long-bone fractures in 130 patients were seen over a 5-year period between 1996 and 2001 in our hospital. 115 fractures in 103 patients were available for study. The data were collected prospectively in weekly audit meetings. Patients were followed until clinical or radiological union occurred or until a secondary procedure for non-union or infection was carried out. RESULTS Surgical debridement was carried out in less than 6 h from injury in 60% of cases and in greater than 6 h from injury in 40% of cases. Infection rates were 10.1% and 10.8%, respectively. CONCLUSIONS We could not demonstrate a significantly increased infection rate in patients in whom surgical debridement occurred greater than 6 h after injury.

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