Background: Infections continue to pose a significant challenge in the management of open tibia fractures, and the role of antibiotics in irrigation fluid remains unclear. Objectives: This study aimed to compare the pre- and post-irrigation bacteria colony counts of open tibia fractures in two irrigation groups: Normal Saline Fluid (NSF) and Normal Saline with Gentamicin (NSG). Patients and Methods: Fifty patients with Gustillo-Anderson I and II open tibia fractures were randomly assigned to either the NSF or NSG group. Pre-irrigation wound swabs were taken before randomization. Post-irrigation samples were collected, and patients were monitored weekly using the SOUTH-AMPTON grading system for six weeks. Patients with clinical wound infection underwent wound culture. Results: Motor cycle injuries accounted for 56% of patients, with a modal age of 20 - 40 years and 75% male. Before irrigation debridement, the bacteria colony counts (BCC) were 20,056 ± 9600 cfu/ml and 22,456 ± 21,150 cfu/ml for NSF and NSG groups, respectively (p = 0.608). Post-irrigation, the BCC decreased to 8892 ± 4830 cfu/ml in the NSF group and 256 ± 341 cfu/ml in the NSG group (p ＜ 0.0001). Seven (28%) NSF patients developed wound infection, primarily with staphylococcus, while none of the NSG patients were infected. Conclusion: Irrigation of open tibia fractures with normal saline impregnated with gentamicin fluid appears to reduce bacterial count load and early wound infection.
Cite this paper
Oyagbesan, O. S. , Adegbehingbe, O. O. and Esan, O. (2024). Effect of Gentamicin Addition to Normal Saline on Microbial Contamination and Early Wound Infection of Open Tibial Fractures. Open Access Library Journal, 11, e1686. doi: http://dx.doi.org/10.4236/oalib.1111686.
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