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Early outcome of culture-negative infection in open fractures of the lower limb: A prospective study. | LitMetric

AI Article Synopsis

  • The study focused on culture-negative infections in open long bone fractures of the lower limb, aiming to understand their rate and outcomes.
  • Conducted from November 2015 to May 2017, it analyzed 231 patients with Gustilo and Anderson Grade III open fractures, noting various clinical details and infection outcomes.
  • Results showed a 17.7% rate of culture-negative infections, with no significant difference in clinical outcomes between culture-positive and culture-negative cases, highlighting the need for aggressive treatment despite the absence of identifiable microorganisms.

Article Abstract

Background: Culture-negative infections in open long bone fractures are frequently encountered in clinical practice. We aimed to identify the rate and outcome of culture-negative infections in open long bone fractures of lower limb.

Methodology: A prospective cohort study was conducted from November 2015 to May 2017 on Gustilo and Anderson Grade III open long bone fractures of the lower limb. Demographic data, injury details, time from injury to receiving antibiotics and index surgical procedure were noted. Length of hospital stay, number of additional surgeries and occurrence of complications were also noted. Patients with infected open fractures were grouped as culture positive or culture negative depending on the isolation of infecting microorganisms in deep intraoperative specimen. The clinical outcome of these two groups was statistically analysed.

Results: A total of 231 patients with 275 open fractures involving the femur, tibia or fibula were studied. There was clinical signs of infection in 84 patients (36.4%) with 99 fractures (36%). Forty-three patients (51.2%) had positive cultures and remaining 41 patients had negative cultures (48.8%). The rate of culture-negative infection in open type III long bone fractures in our study was 17.7%. There was no statistical difference in the clinical outcome between culture-negative and culture-positive infections.

Conclusion: Failure to identify an infective microorganism in the presence of clinical signs of infection is routinely seen in open fractures and needs to be treated aggressively.

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Source
http://dx.doi.org/10.4103/ijmm.IJMM_19_143DOI Listing

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