A survey of French general practitioners on the epidemiology of wounds in family practice

Abstract

Marianne Sarazin,1–3 Florence Roberton,4 Rodolphe Charles,4 Alessandra Falchi,1,2,5 Solange Gonzales Chiappe,1–3 Thierry Blanchon,1,2 Frédéric Lucht,6 Thomas Hanslik1,2,7,8 1INSERM, UMR_S 1136, F-75012, Paris, France; 2Sorbonne Universités, UPMC University Paris 06, UMR_S 1136, F-75012, Paris, France; 3DIM, Centre Hospitalier, 42 700 Firminy, France; 4Département de médecine générale, Faculté de médecine Jacques Lisfranc, F-42023 Saint Etienne, CE France; 5EA 7310, Laboratoire de Virologie, Université de Corse, F-20250 Corte, France; 6CIC-EC3, CHU Saint Etienne, F-42277 Saint-Priest en Jarez, CE France; 7UVSQ, Université de Versailles Saint Quentin, F-78000 Versailles, France; 8Assistance Publique Hôpitaux de Paris, service de Médecine Interne, Hôpital Ambroise Paré, F-92100 Boulogne Billancourt, France Background: To measure the frequency and nature of wounds in patients treated in general practice and to describe the patients' tetanus vaccination status and the sources providing information about this status. Methods: A descriptive, prospective, week-long, national electronic survey was conducted among general practitioners within the Sentinelles network. Results: The participation rate was 12.6% (95% confidence interval [CI], 10.6%–14.6%; 130 general practitioners): 197 patients with wounds were reported, and 175 of them were described. Wound frequency was 1.4 (95% CI, 1.2–1.6) per 100 consultations. These wounds had an acute character in 76 (95% CI, 69.7–82.3) of cases, were mostly of traumatic origin (54.8% of cases; 95% CI, 47.5%–62.1%), were more than 24 hours old (67.1%; 95% CI, 59.1%–75.1%), and were clean, without bone and/or muscle decay (94%; 95% CI, 90.5%–97.5%). Vaccination status was known for 71 (95% CI, 64–78) patients. According to the 2013 immunization schedule, 21% (95% CI, 13.9%–28.1%) of the patients had not updated their vaccinations, mostly among the patients older than 75 years. Conclusion: This survey describes in detail the wounds treated in general practice in France and the associated patients' immunization status. It also shows how difficult it is for general practitioners to assess the risk of contracting tetanus and the disease's development. It highlights as well the fact that the ideal solution to assess tetanus risk is an up-to-date immunization schedule. Keywords: general practice, tetanus, wound, incidence