Use of bacterial cultures in open wound fractures: A prospective cohort study

Abstract

Introduction: Open fractures are a big challenge for surgeons to treat due to wound contamination leading to infection is a well established complication. To overcome this complication, prophylactic antibiotic therapy is routinely recommended for open fractures. Methods: A single center, prospective cohort study was conducted on patients at a tertiary care academic center to assess surgical site infection following fixation of upper and lower limb open fractures. In this study, we aimed to identify the utility of postdebridement cultures for predicting postoperative wound infection with the identification of association between the incidence of infection and factors such as age, gender, fracture site, cause of injury, and the time between injury and presentation at hospital. Results: Postdebridement cultures of 46 patients were collected, of which 28.3% showed microbial growth. During the hospital stay, three patients developed clinically deep wound infection. Postdebridement culture growth was not significantly associated with the development of clinical infection within the hospital stay (P = 0.188). Out of 43 remaining patients, 11 patients develop wound infection on follow up. Four out of 11 had positive growth on initial cultures. Conclusion: In this study, we evaluated that postdebridement wound cultures were not useful in predicting wound infection in the postoperative period.