Evidence map›Paper›PMID 36994304›Full record

ArticleCureus2023

Clinical and Radiological Outcomes of Gustilo-Anderson Type IIIB Open Fractures in 125 Patients.

Almigdad Ali, Ahmed Aljawadi, Ibrahim H Elkhidir, Camille De-Shoulepnikoff, Anand Pillai

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Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Almigdad AliTrauma and Orthopaedics, NHS (National Health Service) Greater Glasgow and Clyde, Glasgow, GBR.
Ahmed AljawadiRadiology, Betsi Cadwaladr University Health Board, Bangor, GBR.
Ibrahim H ElkhidirFaculty of Medicine, University of Khartoum, Khartoum, SDN.
Camille De-ShoulepnikoffOrthopaedics, Centre Hospitalier Universitaire Vaudois, Lausanne, CHE.
Anand PillaiTrauma and Orthopaedics, Wythenshawe Hospital, Manchester, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study describes single-centre outcomes of Gustilo-Anderson type IIIB open fractures in relation to the current standards in the United Kingdom, which aim at performing skeletal fixation and soft tissue coverage at an early stage to salvage the limb and achieve bone union with a minimum infection rate.

methodsA total of 125 patients with 134 Gustilo-Anderson type IIIB open fractures, who had definitive skeletal fixation with soft tissue coverage between June 2013 and October 2021, were prospectively followed up and included in this study.

resultsInitial debridement was performed within 12 hours from the time of injury for 62 (49.6%) patients and within 24 hours for 119 (95.2%) patients (mean= 12.4 hours). Definitive skeletal fixation and soft tissue coverage were achieved within 72 hours for 25 (20%) patients and within seven days for 71 (57%) patients (mean= 8.5 days). The mean follow-up duration was 43.3 (6-100) months, and the limb salvage rate was 97.1%. The occurrence of deep infections was associated with time from injury to initial debridement (p=0.049). Three patients (2.4%) developed deep (metalwork) infections, all three had their initial debridement performed within 12 hours from the time of injury. There was no association between time to definitive surgery and the development of deep infection (p=0.340). Bone union was achieved in 84.3% of patients following their primary surgery. Time to union was associated with fixation modality (p=0.002) and type of soft tissue coverage (p=0.028), and was negatively correlated with time to initial debridement (p=0.002, correlation coefficient -0.321). There was a 0.27-month decrease in time to union for every hour delay in time to debridement (p=0.021).

conclusionDelaying initial debridement or definitive fixation and soft tissue coverage didn't increase the rate of deep (metalwork) infections. The time to achieve bone union was negatively correlated with the time from injury to initial debridement. We advise prioritising surgical technique and availability of expertise over strict adherence to time thresholds of surgeries.

Indexed as

debridementgustilo-andersoninfectionopen fractureorthoplasticunion

Identifiers

PMID36994304
PMCPMC10041781

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