Flap coverage reduces infection rates in tibial fractures, Study reports

Results of multivariate regression with time from injury to coverage, debridement to coverage, and definitive fixation to coverage in the model, to determine which delay measurement was mostly associated with infection was set as the primary outcome. A second multivariate model, including other factors in addition to measures of flap delay, to provide the estimate between delay and infection after adjustment for confounding was laid out.

The study results showed that of 296 adults, 227 were males and 69 were females. The patients with open Gustilo type III tibial fractures requiring flap coverage, 96 (32.4%) became infected. In the multivariate regression, the time from definitive fixation to flap coverage was most predictive of subsequent wound infection (odds ratio 1.04, 95% confidence interval 1.01 to 1.08, n = 260,P = 0.02) among the time measurements.

Furthermore, temporary internal fixation was not associated with an increased risk of infection in both univariate (P = 0.59) or multivariate analyses (P = 0.60). Flap failure was associated with the highest odds of infection (odds ratio 6.83, 95% confidence interval 3.26 to 14.27, P < 0.001).

As a result, it was concluded that coordination of definitive fixation and flap coverage reduce the infection rates in Gustilo type III tibial fractures.

doi: 10.1097/BOT.0000000000002033