A Descriptive Study On The Surgery And The Microbiology Of Gustilo Type III Fractures In An University Hospital In Switzerland / Erlangga YUSUF in Acta Orthopaedica Belgica, Vol 81/2 (Juin 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 81/2 (Juin 2015) . - p.327-332 Titre : A Descriptive Study On The Surgery And The Microbiology Of Gustilo Type III Fractures In An University Hospital In Switzerland Type de document : texte imprimé Auteurs : Erlangga YUSUF, Auteur ; Julia STEINRÜCKEN, Auteur ; Thomas BUCHEGGER, Auteur Année de publication : 2015 Article en page(s) : p.327-332 Langues : Anglais (eng) Mots-clés : Trauma  open fracture  infection  microbiology  antibiotic prophylaxis Résumé : Objective: To describe the epidemiology, the surgical treatment, the microbiology, the antibiotic prophylaxis and the outcome of patients with the most severe type of open fractures. Methods: Retrospective chart reviews of patients with Gustilo type III open fracture admitted to an university hospital in Switzerland between January 2007 and December 2011. The patient’s and fracture’s characteristics, surgery, antibiotic prophylaxis, and microbiology findings at the initial and at the revision surgery were described. Results: Thirty patients were included (83% male, mean age 41 years). More than half of the patients had polytrauma. In all patients, debridement and stabilization surgery (70% using external fixation) were performed at admission. Soft tissue reconstruction was performed in 87% and in 23% immediate bone graft was performed. Antibiotic prophylaxis were given in all patients for a median duration of 9 days (60% received amoxicillin/clavulanic acid). Positive bacterial culture was found in 53% of the patients at initial surgery and in 88% at revision surgery. At initial and revision surgery, 47% and 88% of the pathogens were amoxicillin/clavulanic acid-resistant. Treatment outcome was favorable in 24 of 30 patients (80%) and in six cases (20%) an amputation had to be performed. None of the patients had chronic bone infection. Conclusions: Positive cultures were found often in open fractures. Amoxicillin/clavulanic acid which is often mentioned in many guidelines as prophylaxis in open fractures does not cover the most common isolated organisms. The combination of surgery and antibiotic prophylaxis leads to good outcome in Gustilo type III fracture. Permalink : ./index.php?lvl=notice_display&id=40664 [article] A Descriptive Study On The Surgery And The Microbiology Of Gustilo Type III Fractures In An University Hospital In Switzerland [texte imprimé] / Erlangga YUSUF, Auteur ; Julia STEINRÜCKEN, Auteur ; Thomas BUCHEGGER, Auteur . - 2015 . - p.327-332. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 81/2 (Juin 2015) . - p.327-332 Mots-clés : Trauma  open fracture  infection  microbiology  antibiotic prophylaxis Résumé : Objective: To describe the epidemiology, the surgical treatment, the microbiology, the antibiotic prophylaxis and the outcome of patients with the most severe type of open fractures. Methods: Retrospective chart reviews of patients with Gustilo type III open fracture admitted to an university hospital in Switzerland between January 2007 and December 2011. The patient’s and fracture’s characteristics, surgery, antibiotic prophylaxis, and microbiology findings at the initial and at the revision surgery were described. Results: Thirty patients were included (83% male, mean age 41 years). More than half of the patients had polytrauma. In all patients, debridement and stabilization surgery (70% using external fixation) were performed at admission. Soft tissue reconstruction was performed in 87% and in 23% immediate bone graft was performed. Antibiotic prophylaxis were given in all patients for a median duration of 9 days (60% received amoxicillin/clavulanic acid). Positive bacterial culture was found in 53% of the patients at initial surgery and in 88% at revision surgery. At initial and revision surgery, 47% and 88% of the pathogens were amoxicillin/clavulanic acid-resistant. Treatment outcome was favorable in 24 of 30 patients (80%) and in six cases (20%) an amputation had to be performed. None of the patients had chronic bone infection. Conclusions: Positive cultures were found often in open fractures. Amoxicillin/clavulanic acid which is often mentioned in many guidelines as prophylaxis in open fractures does not cover the most common isolated organisms. The combination of surgery and antibiotic prophylaxis leads to good outcome in Gustilo type III fracture. Permalink : ./index.php?lvl=notice_display&id=40664

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Cote	Support	Localisation	Section	Disponibilité
Revue	Revue	Centre de Documentation HELHa Campus Montignies	Armoires à volets	Document exclu du prêt - à consulter sur place Exclu du prêt

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