Antibiotic Prophylaxis in Open Fractures: Evidence, Evolving Issues, and Recommendations.

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Abstract

[Indexed for MEDLINE] 2. J Orthop Surg Res. 2018 Apr 13;13(1):83. doi: 10.1186/s13018-018-0793-2. Open pelvic fracture: the killing fracture? Hermans E(1), Edwards MJR(2), Goslings JC(3), Biert J(2). Author information: (1)Department of Surgery, Radboud University Medical Center, Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. erik.hermans@radboudumc.nl. (2)Department of Surgery, Radboud University Medical Center, Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. (3)Department of Surgery, Onze Lieve Vrouwe Gasthuis Amsterdam, PO-BOX 95500, 1090 HM, Amsterdam, The Netherlands. BACKGROUND: Open pelvic fractures are rare but represent a serious clinical problem with high mortality rates. The purpose of this study was to evaluate the outcomes of open pelvic fractures in our clinic and to compare the results from our patient group with those of closed fractures and with the literature from the past decade. METHODS: Data of patients older than 16 years of age who were admitted to our hospital with a pelvic fracture between January 1, 2004, and December 31, 2014, were analyzed. The collected data were patient demographics, mechanism of injury, RTS, ISS, transfusion requirement during the first 24 h, Gustilo-Anderson and Faringer classification, number and type of interventions complications, mortality, and length of stay. RESULTS: Twenty-four of 492 patients (5% of all pelvic fracture patients) had an open fracture. Their mean age was 36 years, the mean ISS was 31, and the mean number of transfused packed red blood cells was 5.5. These numbers were all significantly higher than in the patients with a closed fracture, although they were comparable to other studies with open fractures. The mortality was 4% in the open group versus 14% in the closed group (p = 0.23). The reported mortality in the literature ranges between 4 and 45%. CONCLUSION: Open pelvic fractures are relatively rare but are a cause of significant morbidity. In this series, we treated patients with open pelvic fractures successfully, with a survival rate of 96%. There was no significant difference in survival rate between open and closed pelvic fractures. Compared with other studies, the mortality in our study was relatively low. DOI: 10.1186/s13018-018-0793-2 PMCID: PMC5899387