Timing of Debridement in Low-Grade Open Forearm Fractures Does Not Affect Infection Risk: A Retrospective Study.

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Infectious Disease Prevention

Background:

• Current protocols emphasize prompt surgical debridement for open extremity fractures.
• Evidence linking timing of debridement to infection rates remains inconsistent.
• This study investigates delayed surgical treatment for low-grade open forearm fractures.

Purpose of the Study:

• To determine if delaying surgical debridement beyond 24 hours impacts infection rates in low-grade open forearm fractures.
• To evaluate the safety and efficacy of prioritizing antibiotic administration over immediate surgical intervention.

Main Methods:

• Retrospective review of 62 patients with Gustilo type 1 or 2 open forearm fractures (2017-2020).
• Standard treatment included emergency department irrigation and 72-hour intravenous antibiotics.
• Outcome measures: time to surgery, infection rate, and union rate.

Main Results:

• Median time to surgery was 47 hours, with 69% of patients operated on after 24 hours.
• A low infection rate of 1.6% (1 case) was observed.
• The non-union rate was 4.8% (3 cases).

Conclusions:

• Delayed surgical treatment for low-grade open forearm fractures appears safe in patients without risk factors.
• Deferring surgery did not lead to an increased likelihood of infection.
• Treatment protocols could prioritize timely antibiotic administration over urgent surgical intervention for these fractures.