Prospective cohort study of 736 patients with open long bone fractures at three Canadian Level 1 trauma centers (2001–2009), asking whether time from injury to initial surgical debridement — or time to antibiotics — independently predicts development of deep infection.
When you see an open fracture, your infection risk conversation should center on Gustilo grade and whether it's a tibia — not on whether you get to the OR before an arbitrary 6-hour cutoff.
For low-grade upper extremity open fractures especially, this study supports elective next-morning debridement in a dedicated trauma theater over a rushed middle-of-the-night case, as long as antibiotics and splinting are started promptly.
Prospective cohort study of 736 patients with open long bone fractures at three Canadian Level 1 trauma centers (2001–2009), asking whether time from injury to initial surgical debridement — or time to antibiotics — independently predicts development of deep infection.
When you see an open fracture, your infection risk conversation should center on Gustilo grade and whether it's a tibia — not on whether you get to the OR before an arbitrary 6-hour cutoff.
For low-grade upper extremity open fractures especially, this study supports elective next-morning debridement in a dedicated trauma theater over a rushed middle-of-the-night case, as long as antibiotics and splinting are started promptly.