Efficacy of cultures in the management of open fractures

Two hundred forty-five open fractures were reviewed retrospectively to determine the prognostic value of wound bacterial cultures concerning deep infections requiring surgical management. Only 8% of organisms grown on predebridement cultures eventually caused infection; 7% of cases with negative predebridement cultures became infected. Of cases that did become infected, predebridement cultures grew the infecting organism only 22% of the time. Postdebridement cultures were more accurate in predicting infection; however, of cases that became infected, the infecting organism was present on postdebridement cultures only 42% of the time. It is concluded that predebridement and postdebridement bacterial cultures from open fracture wounds are of essentially no value, and it is recommended that they not be done.