Delayed irrigation, debridement did not independently yield higher reoperation risk
DENVER — Delayed irrigation and debridement did not independently increase the risk of unplanned reoperation for infection or wound-related complications in patients with open extremity fractures, according to results presented here.
To determine if risk for reoperation was independently associated with time to irrigation and debridement, Herman Johal, MD, and colleagues performed a matched cohort and propensity-adjusted regression analysis of patients in the Fluid Lavage of Open Wounds Study dataset, controlling for injury, patient and treatment-related confounding factors.
In his presentation at the Orthopaedic Trauma Association Annual Meeting, Johal noted patients who received early irrigation and debridement tended to be younger, have a high incidence of type III open fractures, were more severely contaminated, had higher energy injuries and were more likely to have lower extremity fractures or tibial fractures.
“The unadjusted analysis that we performed showed that patients who received early irrigation and debridement were more likely to require reoperation,” Johal said.
Propensity-adjusted analysis showed no differences in reoperation rates between time to irrigation before or after 6 hours, according to Johal.
“After we looked at it as a continuous variable, similarly, we did not find that earlier irrigation and debridement led to decreased incidence of infection and healing-related complications,” Johal said. – by Casey Tingle
Johal H, et al. Abstract 92. Presented at: Orthopaedic Trauma Association Annual Meeting; Sept. 25-28, 2019; Denver.
Disclosure: Johal reports no relevant financial disclosures.