TY  - JOUR
T1  - Commentary on an Article by Christopher J. Lenarz, MD, et al.: “Timing of Wound Closure in Open Fractures Based on Cultures Obtained After Debridement”
AU  - Swiontkowski, Marc F.
Y1  - 2010/08/18
N1  - 10.2106/JBJS.J.00686
JO  - The Journal of Bone & Joint Surgery
SP  - e12 1
EP  - 1
VL  - 92
IS  - 10
N2  - 
Since the time of Hippocrates, the goal of management of an open fracture has been to limit infection. Infection dramatically increases the risk of amputation, and thus this has been an appropriate focus. The role of cultures obtained during initial and subsequent wound debridement procedures has long been studied in the orthopaedic community. This Level-IV study endeavors to evaluate the role of serial cultures following wound debridement in improving the long-term outcomes for open fractures. As is the case with most retrospective series, substantial loss to follow-up is apparent, with complete data available for only 346 of the 422 open fractures. The overall deep infection rate of 4.3% is laudable in this group of seriously injured patients. The finding that fractures requiring multiple wound debridement procedures because of serial positive cultures and those in patients with diabetes or obesity have higher infection rates is confirmatory. Of note is the somewhat surprising fact that when wounds were closed in the presence of positive cultures, there was no significantly increased risk of deep infection.

SN  - 0021-9355
M3  - doi: 10.2106/JBJS.J.00686
UR  - http://dx.doi.org/10.2106/JBJS.J.00686
ER  -