Risk factors associated with infection in tibial open fractures

Marcos Almeida Matos; Rômulo Neves Catro-Filho; Bruno Vieira Pinto da Silva

doi:10.31053/1853.0605.v70.n1.20279

Autores

Marcos Almeida Matos Bahian School of Medicine and Public Health. Salvador-Bahia.
Rômulo Neves Catro-Filho Roberto Santos General Hospital. Salvador-Bahia.
Bruno Vieira Pinto da Silva Roberto Santos General Hospital. Salvador-Bahia.

DOI:

https://doi.org/10.31053/1853.0605.v70.n1.20279

Palavras-chave:

open fracture, infection, treatment, trauma

Resumo

Background. The objective of the treatment of open fracture is to prevent infection, stabilize the bones, and restore function. However, infection is the most important step in achieving the latter aims. Objective. The objective of the current paper is to find risk factors associated with infection in a sample of tibial open fractures. Patients and Methods. A retrospective analysis was carried out. The study included all patients who underwent to tibial open fracture treatment in the Hospital Geral Roberto Santos-HGRS, Salvador, Bahia, Brasil, from March to October, 2009. Patients under the age of eight, with multiple fractures or suffering from systemic or bone disease were excluded. Clinical and demographic data were collected and Patient outcomes were divided into two groups: Group 1 comprises those without infection whereas group 2 comprises those with lesions which became infected. The two groups were evaluated in search for associated factors that could lead to infection. Results. We studied 50 patients. Our overall infection rate was 14 (28%; CI95%=15.5-40.5). Infection was significantly associated with place of trauma (OR 3.78; CI95%=1.4-5.5;
p=0.02), and time delay superior to 24 hours (OR 3.4; CI95%=1.4-20.8; p=0.03). Fractures graded as Gustilo I, II and IIIA had a lower chance for infection compared to Gustilo IIIB and IIIC (OR 4.32; CI95%=1.3-19.1; p=0.01). Fractures graded Tscherne III and IV had a higher chance for infection, and it was the most significant isolated factor (OR 8.07; CI95%=2.4-47.1; p<0.00).

Conclusions. We confirmed the relationships between infection with Gustilo classification and as well as between infection and trauma from the countryside of Bahia State. We also presented a new relationship between soft tissue and infection, and another relating time delay of more than 12 hours with infection.

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