胫骨开放性骨折不同清创时机术后感染的临床研究

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Abstract Objective To investigate the relationship between the time of first debridement and postoperative infection in open tibial fractures.Methods The clinical data of 215 patients with open fracture of tibia admitted from January 2012 to January 2017 were analyzed retrospectively.According to the time from the injury to the operation，the patients were divided into four groups：group A (T≤6 h)，group B (6 h＜T≤12 h)，group C (12 h＜T≤24 h) and group D (T＞24 h) respectively，to analyze the difference of infection rate between early debridement and delayed debridement after the first debridement.Results 6 cases of 65 cases in group A were infected，and the infection rate was 9.2%；9 cases in 95 cases in group B were infected，and the infection rate was 9.5%；4 cases of 36 cases in group C were infected，and the infection rate was 11.1%；2 cases of 19 case in group D were infected，and the infection rate was 10.5%.There was no statistical significance between any of the four groups.Accroding to fracture (GustiloAnderson) classification，there were 62 cases of type Ⅰ with 2 cases infected，and the infection rate was 3.2%；8 cases of type Ⅱ cases，and the infection rate was 8.2%；26 cases of type Ⅲ A with 3 cases infected，and the infection rate was 11.5%，25 cases of type Ⅲ B with 7 cases infected，and the infection rate was 28%，4 cases of type Ⅲ C type with 1 case infected，and the infection rate was 25%.There was statistically significant difference between the five groups.Conclusion The prolonged time from injury to debridement of open tibial fractures does not increase the postoperative infection rate.And the postoperative infection of open tibial fractures is mainly related to the severity of fractures.

Key words： tibia open fracture debridement infection rate Gustilo-Anderson classification

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