Objective To retrospectively analyze and classify 23 open fractures that resulted in severe infection, in order to provide evidence that can be used in future disaster scenarios.
Methods Based on medical records of 23 cases of open fracture and subsequent bacterial infection, we analyzed the clinical diagnosis, treatment, laboratory tests, bacterial smear of wound secretion, and the bacterial culture of the wound secretion. We then analyzed which antimicrobial agents were used and how they were applied, and the subsequent effect on controlling the serious infection.?
Results All cases were related to seismic injury and belonged to class VI open fracture. Eight cases were male and 15 were female. All cases had similar symptoms such as chills, fever, large scale muscle necrosis, and severe infection. A direct smear of the wound showed that the number of cases with one bacterial infection was 6 (26.09%), the number that had double bacterial infections was 12 (52.18%), and the number with multiple bacterial infections was 5 (21.74%).There were 18 strains of 11 types of bacteria recovered from wound samples.
Conclusion Early treatment with the joint application of multiple antibacterial agents, early debridement, and adequate drainage all helped to control the infection and avoid nosocomial infection. Employing these strategies in the future will control infection in disaster situations.
Citation： YANG Jiahong,ZHAO Luping,WU Qi,CHEN Gao,WEN Yuan,YUAN Cehngliang,LUO Wanrong,ZHANG Dazhi. Treatment of 23 Cases of Axial Open Fractures and Resulting Severe Infection in the Sichuan Wenchuan Earthquake in Front-line Hospital of Grade III Level A. Chinese Journal of Evidence-Based Medicine, 2009, 09(3): 273-274. doi: 10.7507/1672-2531.20090052 Copy