Open Fracture Research Paper

1. INTRODUCTION
Open or compound fractures are fractures that communicate with the outside environment through a skin wound. Approximately 3-4% of all fractures are open fractures. Open fracture stands one of the common causes of acute health issue. Improper initial management of open fracture can lead to significant long-term morbidity and, potentially, mortality. Open fractures are usually caused by high-energy trauma such as road traffic accident (RTA), fall from height, gunshots, assault, machine injury and others (Solagberu, 2011). Among them, the commonest cause is traffic crashes. Over 1.2 million people die each year, and up to 50 million people injure seriously with long-term adverse health consequences on the world’s roads

Staphylococcus aureus is the usual pathogen, and other organisms such as Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa are sometimes involved. Occasionally, anaerobic organisms (clostridia, anaerobic streptococci or Bacteroides) appear in contaminated wounds (Nayagam, 2010). In Yangon General Hospital, the common bacterial pathogens isolated in open fracture wound infection were Pseudomonas species (31.15%) followed by Staphylococcus aureus, Escherichia coli. Other organisms such as Coagulase negative staphylococci and Enterococcus species, Proteus species, Citrobacter species, Klebsiella species, Beta haemolytic streptococci were found in open fracture wound infection (Aye-Mya-Thu, 2010).
Open fracture management is a complex and integrated approach, including preoperative prophylactic antibiotics, thorough irrigation and debridement, fracture stabilization, and postoperative antibiotic management. Although surgical debridement and fixation are of utmost importance for preventing open fracture infections, the use of antibiotics to prevent infection is still an interesting topic (Chen et al.,