This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

E. Patchen Dellinger, MD; Stephen D. Miller, MD; Margaret J. Wertz, MN, RN; Martin Grypma, MD; Beth Droppert, RN; Paul A. Anderson, MD

Arch Surg. 1988;123(11):1320-1327.

Abstract
• Two hundred forty consecutive patients admitted for operative treatment of an open fracture of the arm or leg were followed up prospectively for the development of fracture infection. The independent risk of fracture infection was increased in patients with grade IIIB or IIIC fractures, internal or external fixation, lower-leg fracture, any blood transfusion, or injuries resulting from motorcycle accidents or motor vehicle—pedestrian accidents. By stepwise multivariate logistic regression, the most significant risk factors were the grade of the fracture, internal or external fixation, and fractures of the lower leg. These risk factors all represent local wound characteristics, and we conclude that the most important actions by the surgeon to prevent infection involve local wound care. There was no relation between the timing of antibiotic administration or duration of antibiotic therapy and infection risk.

(Arch Surg 1988;123:1320-1327)

Author Affiliations
From the Departments of Surgery (Dr Dellinger and Mss Wertz and Droppert) and Orthopaedics (Dr Anderson), Harborview Medical Center, University of Washington, Seattle; and the Division of Orthopaedics, Foothills Hospital, University of Calgary, Alberta (Drs Miller and Grypma).

Footnotes
Accepted for publication Aug 26, 1988.

Read before the Eighth Annual Meeting of the Surgical Infection Society, San Francisco, May 6, 1988.

Reprint requests to Department of Surgery, Harborview Medical Center, ZA-16, University of Washington School of Medicine, Seattle, WA 98104 (Dr Dellinger).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Locally-administered antibiotics in wounds in a limb
Branstetter et al.
J Bone Joint Surg Br 2009;91-B:1106-1109.
ABSTRACT | FULL TEXT  

The Urgency of Surgical Debridement in the Management of Open Fractures
Werner et al.
J Am Acad Orthop Surg 2008;16:369-375.
ABSTRACT | FULL TEXT  

Prevention of Perioperative Infection
Fletcher et al.
JBJS 2007;89:1605-1618.
FULL TEXT  

A review of the management of open fractures of the tibia and femur
Giannoudis et al.
J Bone Joint Surg Br 2006;88-B:281-289.
FULL TEXT  

Anemia, Allogenic Blood Transfusion, and Immunomodulation in the Critically Ill
Raghavan and Marik
Chest 2005;127:295-307.
ABSTRACT | FULL TEXT  

Open Fractures of the Calcaneus: Soft-Tissue Injury Determines Outcome
Heier et al.
JBJS 2003;85:2276-2282.
ABSTRACT | FULL TEXT  

Surgical Infection Society--Trials and Tribulations: The Importance of Clinical Trials
Dellinger
Arch Surg 1998;133:1192-1197.
FULL TEXT  

Blood Transfusion Increases the Risk of Infection After Trauma
Agarwal et al.
Arch Surg 1993;128:171-177.
ABSTRACT