开放性骨折清创期细菌培养的应用价值

目的　讨论四肢开放性骨折时清创前、后细菌培养的应用意义。方法　分析自从 1995年 4月以来 ,89例 93处开放骨折清创期采用定量细菌培养结果和深部感染关系。结果　清创前培养阳性率 81 7% ,清创后为 2 3 7% ;伤口感染率为2 2 6 % ,深部感染 8 5 %。清创前培养结果的价值明显不如清创后结果。结论　清创前细菌培养应当废弃 ,用Gustilo分类加清伤后伤口污染程度来估计开放骨折是否发生深部感染更有用

The Value of Bacterial Cultures in Open Fractures through a Debridem ent

Objective To discuss the significance of bacterial cultures in open fractures through debridement Methods The value of peroperative cultures in 93 open fractures extremity was assessed since April of 1995 Results Twenty one infections were identified, for an incidence of 22 6% The dept infection was 8 5% The predebridement culture was positive in 81 7% and the postdebridement culture was positive in 23 7% There was more significance in postdebridement culture than the predebridement culture Conclusion Predebridement bacterial cultures of open fracture wound should not be done; With Gustilo s classification and postdebridement bacterial culture are more useful to prediction of deep wound infection