Impact of the 6 Hour Rule upon the Infection Rate in Open Tibia Shaft Fractures

International Journal of Medical Science

© 2017 by SSRG - IJMS Journal

Volume 4 Issue 1

Year of Publication : 2017

Authors : Dr Goutam Kumar Satpathy, Dr Sunil Kumar Kar and Dr Dillip Kumar Chand

10.14445/23939117/IJMS-V4I1P102

How to Cite?

Dr Goutam Kumar Satpathy, Dr Sunil Kumar Kar and Dr Dillip Kumar Chand, "Impact of the 6 Hour Rule upon the Infection Rate in Open Tibia Shaft Fractures," SSRG International Journal of Medical Science, vol. 4,  no. 1, pp. 1-5, 2017. Crossref, https://doi.org/10.14445/23939117/IJMS-V4I1P102

Abstract:

The tibia is the most frequent site of an open fracture, with incidences ranging from 49.4% to 63.2%. This is attributable in part to the relatively thin soft-tissue covering along its anteromedial surface. The tibia is also more susceptible to infection, with a reported infection rate 10 to 20 times higher than open fractures in other areas. The management of open fracture tibia represents an orthopaedic emergency. Early aggressive management of these debilitating injuries within the first 6 hours has been encouraged in order to minimise the risk of infection and long term sequelae. Debridement and lavage of the wound, followed by stabilisation of the bone and closure of the soft-tissue envelope are all considered essential. However, the available scientific evidence supporting the timing of the management of open fracture and the “Six-hour rule” itself, are unclear. The purpose of this study was to evaluate the infectious outcome of open tibia fractures relative to the time from injury to operative lavage and debridement. Eighty nine patients with consecutive open tibia fractures were retrospectively reviewed. Gustilo - Anderson classification was followed .Of these, 53 patients were operated within 6 hours of the time of injury and 36 patients beyond 6 hours of injury both within maximum of 24 hours with an average follow-up of 6.3 months. Fourteen patients (15.73%) developed infection out of which 8(9%) patients were from <6 hour group and 6(6.7%) patients from >6 hour group which was statistically insignificant .The result indicates that the time of surgical treatment from time of injury does not have impact upon the infection rates in open tibia fractures.

Keywords:

Tibia, Open Fracture, Six Hour Rule, Debridement.

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