Assessment of Severe Extremity Wound Bioburden at the Time of Definitive Wound Closure or Coverage: Correlation With Subsequent Postclosure Deep Wound Infection (Bioburden Study)

Michael J Bosse; Clinton K Murray; Anthony R Carlini; Reza Firoozabadi; Theodore Manson; Daniel O Scharfstein; Joseph C Wenke; Mary Zadnik; Renan C Castillo; Major Extremity Trauma Research Consortium (METRC)

doi:10.1097/BOT.0000000000000805

Back

Assessment of Severe Extremity Wound Bioburden at the Time of Definitive Wound Closure or Coverage: Correlation With Subsequent Postclosure Deep Wound Infection (Bioburden Study)

Journal article

Peer reviewed

Assessment of Severe Extremity Wound Bioburden at the Time of Definitive Wound Closure or Coverage: Correlation With Subsequent Postclosure Deep Wound Infection (Bioburden Study)

Michael J Bosse, Clinton K Murray, Anthony R Carlini, Reza Firoozabadi, Theodore Manson, Daniel O Scharfstein, Joseph C Wenke, Mary Zadnik, Renan C Castillo and Major Extremity Trauma Research Consortium (METRC)

Journal of orthopaedic trauma, Vol.31 Suppl 1(1), pp.S3-S9

04/2017

DOI: 10.1097/BOT.0000000000000805

PMID: 28323795

View Online

Abstract

Infection remains the most common and significant complication after high-energy fractures. The Bioburden Study is a multicenter, prospective, observational cohort study of wound bacterial bioburden and antibiotic care in severe open lower extremity fractures. The aims of this study are to (1) characterize the contemporary extremity wound "bioburden" at the time of definitive wound closure; (2) determine the concordance between polymerase chain reaction results and hospital microbiology; (3) determine, among those who develop deep infections, the concordance between the pathogens at wound closure and at deep infection; and (4) compare the probability of deep infection between those who did and did not receive an appropriate course of antibiotics based on bioburden at the time of wound closure. To address these aims, sites collected tissue samples from severe lower extremity injuries at the time of wound closure and at first surgery for treatment of a deep infection, nonunion, flap failure, amputation, or other complications (because these surgeries may be due to undetected infection). Otherwise, if no further surgical treatment occurred, participants were followed for 12 months. The study was conducted at 38 US trauma centers and has enrolled 655 participants aged 18-64 years. This is the first large multi-institutional study evaluating the wound bioburden of severe open tibia fractures and correlating this bioburden with the risk of wound complications after definitive soft tissue closure.

Tibial Fractures - epidemiology

United States - epidemiology

Wound Closure Techniques - statistics & numerical data

Humans

Middle Aged

Cost of Illness

Male

Tibial Fractures - microbiology

Statistics as Topic

Young Adult

Anti-Bacterial Agents - therapeutic use

Tibial Fractures - surgery

Surgical Wound Infection - drug therapy

Adult

Female

Colony Count, Microbial - statistics & numerical data

Bacterial Infections - microbiology

Surgical Wound Infection - epidemiology

Bandages - microbiology

Trauma Severity Indices

Bacteria - isolation & purification

Bacterial Infections - prevention & control

Adolescent

Bacterial Infections - epidemiology

Surgical Wound Infection - microbiology

Details

Title: Subtitle: Assessment of Severe Extremity Wound Bioburden at the Time of Definitive Wound Closure or Coverage: Correlation With Subsequent Postclosure Deep Wound Infection (Bioburden Study)
Creators: Michael J Bosse
Clinton K Murray
Anthony R Carlini
Reza Firoozabadi
Theodore Manson
Daniel O Scharfstein
Joseph C Wenke
Mary Zadnik
Renan C Castillo
Major Extremity Trauma Research Consortium (METRC)
Contributors: Michael C Willey (Contributor) - University of Iowa, Orthopedics and Rehabilitation
Resource Type: Journal article
Publication Details: Journal of orthopaedic trauma, Vol.31 Suppl 1(1), pp.S3-S9
DOI: 10.1097/BOT.0000000000000805
PMID: 28323795
NLM abbreviation: J Orthop Trauma
ISSN: 0890-5339
eISSN: 1531-2291
Language: English
Date published: 04/2017
Academic Unit: Orthopedics and Rehabilitation; Injury Prevention Research Center
Record Identifier: 9984083278402771

Metrics

44 Record Views

18 Times Cited - Web of Science

See more details