Can Open Fracture Debridement Improve Postoperative Wound Infection?.

ABSTRACT

Damaged soft tissues provide an ideal environment for bacterial growth and subsequent infections. This study was to evaluate the spectrum of bacterial contamination of predebridment and postdebridment measures in patients with open fractures and to study the best timing suitable for eradication of the micro-organism in a tertiary hospital. These studies was conducted over 112 patients open fracture wound episodes with or without overt signs of infection were included in this study. A patient is considered to have an open fracture wound infection when clinical signs and symptoms of infection were present. Four swabs were taken for each patient, the first was taken as pre debridement swab, the second was post debridement swab, the third swab was after 3 days after debridement and the fourth was 7 days after debridement. Specimens were examined aerobically and anaerobically. Of the 112 wound specimens examined by Gram stain, 66.96% were positive for the presence of bacteria. The Gram-positive and Gram-negative bacteria accounted for 58.66% and 41.33%, respectively. S. aureus (44.2%) was the dominant isolate. The most effective drugs against the tested Gram-positive were amoxicillin/clavulonic acid, erythromycin, vancomycin, cefuroxime and ampicillin. Whereas, the most effective drugs against the tested Gram-negative bacteria were gentamicin, ciprofloxacin, tazocin, imipenem and aztreonam. Postoperative bacterial infection can be decreased if debridement was done at optimum time.