Infection Rate in Pediatric Compound Depressed Fractures FollowingPrimary Replacement of Bone Fragments

Abstract

AbstractBackground: Compound depressed fractures is one of thecommon neurosurgical emergencies. Children presenting withthis type of head injury, need careful and rapid decision toavoid lifelong morbidities as neurologic deficit. Surgery,according to most authors, is the gold standard in management,however, post-operative wound infection remains a seriouscomplication.Aim of Study: The purpose of this study was to identifyfrequency of infection in pediatric population with compounddepressed skull fractures managed by placement of bone chipsafter cleaning with betadine and antibiotic.Patients and Methods: This study included 41 patientsaged less than 16 years. All patients had Glasgow Coma Scaleof 15. Surgery was done within 24 hours following trauma.Full clinical examination, motor power assessment was andbrain CT scan was done to all patients. Bone fragments wereplaced after cleaning with betadine, saline and gentamicinantibiotic. Patients were assessed for wound infection followingsurgery for the next 3 month.Results: Patients' mean age was 7.8 years, 80.5% of themwere males. The site of the compound depressed fracture wasleft frontal in 36.6% of cases. Fractures were complicated bydural tear in 43.9% of cases. Fall from height was the com-monest mode of trauma in 41.5% of patients. Infection ratewas 7.3% of the cases.Conclusion: The risk of infection in pediatric compounddepressed fractures managed by placement of bone chips aftercleaning with betadine and saline with gentamicin antibioticin the first 24 hours following surgery was low.