1181 Surgical Sample Collection and Non-Touch Technique for Tibial Fractures Treated with Fine Wire Frames: First Cycle Audit

Abstract

Abstract Aim Tibial osteomyelitis can be an incredibly complex condition to treat, and often causes great pain and reduced quality of life for the patient throughout the treatment and rehabilitation phase. Often, fine wire fixators (FWF) are used for the most severe cases, with infection and concordant bone loss/deformity correction required. A robust diagnostic protocol is required to ensure the correct antibiotics are used for treatment. Method The microbiology sampling and diagnostic process for patients with tibial osteomyelitis treated with FWF were audited at a major trauma centre according to British Orthopaedic Association (BOA) guidelines. Fifty-one patients met inclusion criteria. Results Poor compliance was defined as <70% guidelines followed. Empirical antibiotics free period prior to diagnostic sampling was achieved in 46/51 cases (90.2%), five separate documented samples for microbiology sampling was achieved in 26/51 cases (51.0%), and documentation of sterile, non-touch, separate instrument technique for microbiology samples was documented in 5/51 cases (9.8%) We recommend a pre-written template for clinicians on admission of patients with suspected osteomyelitis detailing empirical antibiotic status prior to diagnostic sampling, a template for the surgical team to detail site and technique used for microbiology sampling, and increased communication between surgeons and microbiologists to confirm and document number of samples taken. Conclusions Tibial osteomyelitis can be very difficult to manage, with the initial culture-specific antibiotic(s) being employed crucial in the treatment process. Achieving a robust and error-free diagnostic process is vital in combating this debilitating condition, and a key goal for the trauma and orthopaedics department.