Current Concept Review: Risk Factors for Infection Following Open Fractures

Abstract

Jeffrey Coombs,1,2 Damien Billow,1 Cesar Cereijo,1 Brendan Patterson,1 Stephen Pinney1 1Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA; 2Case Western Reserve University School of Medicine, Cleveland, OH, USACorrespondence: Stephen Pinney, Email [email protected]: Infection following open fracture is a significant source of morbidity and mortality. Therefore, a central tenet of treatment is to minimize the risk of infection. The initial risk of infection is determined by wound characteristics, such as size, soft tissue coverage, vascular injury, and contamination. While no consensus exists on optimal antibiotic regimen, early administration of prophylactic antibiotics, within an hour of injury, when possible, has been shown definitively to decrease the risk of infection. Infection risk is further reduced by early irrigation with normal saline and aggressive debridement of devitalized tissue. Patient factors that increase risk of infection following open fracture include diabetes mellitus, smoking, male gender, and lower extremity fracture.Keywords: open fracture, antibiotic prophylaxis, trauma, infection

Keywords

• open fracture
• antibiotic prophylaxis
• trauma
• infection