Research Article: Infection Rates in Open Fractures of the Tibia: Is the 6-Hour Rule Fact or Fiction?

Date Published: October 27, 2011

Publisher: SAGE-Hindawi Access to Research

Author(s): Ameya S. Kamat.

http://doi.org/10.4061/2011/943495

Abstract

Aims. Emergency debridement has long been the standard of care for open fractures of the tibia as infection is an important complication. The timing of operative debridement can be debated. We review open fractures of the tibia and compare infection rates in those that were operated on within and after 6-hours. Method. 103 consecutive open fractures of the tibia were reviewed. The data was analysed retrospectively with regard to severity of fracture and incidence of infection. Infection rates over a three-month period were compared between the two groups. Results. 12 (11.6%) patients developed an infection within the first 3 months of injury. 7 of which were taken to theatre within 6-hours, and 5 after 6-hours. No significant differences were found between these two groups. Conclusion. There is no significant difference in timing of surgery. Initial basic interventions may play more of a role in limiting the risk of infection.

Partial Text

Emergency operative measures have long been the standard of care for open fractures of the tibia as deep infection is the most important complication. While there is unanimous agreement with regards to early operative debridement of wounds, there have been only a few articles reflecting timing [1, 2]. Debridement of the open wound within six hours after the injury is a widely accepted standard of care [3].

103 consecutive open fractures of the tibia were reviewed amongst hospitals in the Wellington region of New Zealand over the last 10 years.

103 consecutive open fractures of the tibia were reviewed. 62 patients were taken to theatre for surgical debridement within 6-hours and 41 after 6-hours.

The data gathered over the last decade indicates that there was no significant difference in terms of timing of surgery.

 

Source:

http://doi.org/10.4061/2011/943495

 

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