A Prospective Comparative Study of Pre-debridement and Post-debridement Cultures in Open Fractures of the Extremities

Introduction Amputations and recurrent infections are two terrible outcomes of open fractures that can leave patients with permanent impairments. Rapid and effective treatment can protect patients from open fracture sequelae and the long-term financial burden these injuries frequently cause. Over 50% of open fractures are caused by high energy trauma, which most frequently happens in car accidents or severe falls. There hasn't been much research done on the first bacterial ecology of open fracture wounds in the Indian environment. Therefore, the need of the current assignment was to assess the effectiveness of pre-debridement and post-debridement culture in open fractures of the extremities. Methodology A prospective comparative study was carried out with 65 patients who were hospitalized from the OPD and Emergency departments at the R. L. Jalappa Hospital and Research Center. The time frame of study was between December 2020 and July 2022. Prior to the trial, each participant's written informed consent was obtained and strict protocol was followed in accordance with the Institutional Ethics Committee. Results Among the study participants, the majority of cases (26.15%) belonged to the 21-30 years of age group. A total of 14 participants belonged to the 41-50 years of age group. Out of the total, nine patients were aged less than 20 years. Out of the total, in pre-debridement culture the majority of cases had presence of growth of Staphylococcus aureus followed by Acinetobacter species, Enterobacter species and Pseudomonas species. Only six patients had growth of Klebsiella species. After debridement and treatment for bacterial infection, on subsequent culture examination, no growth was found among 61 patients. Although in four patients, there was presence of Pseudomonas species, Enterobacter species and Proteus microorganisms. Conclusion Although the validity of sequential cultures has been questioned in a number of investigations, this study has demonstrated that debridement cultures have a significant impact in postoperative infection. Debridement culture is therefore advised to offer information about the selection of antimicrobial medication, which when paired with a complete wound debridement will permit an early wound closure and better overall outcome functionally.