Photographic wound documentation after open fracture

Area of Science:

• Orthopaedic Surgery
• Trauma Care
• Infection Control

Background:

• Over 3000 open fractures occur annually in the UK, necessitating prompt assessment and treatment.
• Complications from open fractures can be severe if not managed meticulously.
• Working party recommendations advocate for immediate wound photography before dressing application to prevent infection.

Purpose of the Study:

• To assess the current practice of photographing open fracture wounds in UK accident and emergency departments.
• To identify barriers to implementing recommended photographic procedures.
• To evaluate adherence to guidelines aimed at reducing nosocomial infection in open fracture cases.

Main Methods:

• A telephone questionnaire survey was conducted.
• Fifty-one accident and emergency departments across the UK participated.
• The survey focused on the availability and accessibility of cameras for photographing open fracture wounds.

Main Results:

• 41% of surveyed departments were unable to photograph open fracture wounds.
• An additional 20% lacked camera access outside of standard office hours.
• These findings indicate a significant gap between recommended practice and actual implementation.

Conclusions:

• Current practices in UK accident and emergency departments fall short of recommended guidelines for managing open fractures.
• Lack of immediate photographic documentation poses a risk for infection and complications.
• Simple, cost-effective recommendations by the Working Party are not being consistently followed, highlighting a need for improved infrastructure and training.