orthopedics-2019-scientifictracks

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November 13-14, 2019 | London, UK

ORTHOPEDICS, OSTEOPOROSIS & TRAUMA

International Conference on

Journal of Orthopaedics Trauma Surgery and

Related Research

Orthopedics 2019

November 13-14, 2019

J Orthop Trauma Surg Rel Res, Volume 14

Volume: 14 | ISSN: 1897-2276

Open fractures: Should they be managed in centres with no orthoplastic service?

Louai Abdeh, John McNamara

Manchester Royal Infirmary, UK

Background

: BOAST guidelines for open fractures (2017) recommend that open fractures should be managed by an orthoplastic

team.

Aim

: This study aims to evaluate how the absence of an on-site plastics service in a major trauma centre can impact the outcomes

of open fracture management.

Setting

: Manchester Royal Infirmary, NHS Major Trauma Centre, UK

Methods

: A retrospective service evaluation exercise was conducted to assess the outcomes of open fractures managed at our

centre over a 15-month period. This was audited against BOAST guidelines. The outcomes of patients with open fractures

requiring plastics input was compared to those who did not require involvement of plastics.

Results

: 57 patients were identified during the study’s period. Initial management was carried out solely by Trauma &

Orthopaedic surgeons. Following initial debridement, 10 patients were identified as requiring plastics input for wound closure.

This was sought via an online referral system to another hospital which is part of our trust. The results of the study demonstrated

that definitive wound closure within 72 hours, as advised by BOAST guidelines, was achieved in only 10% of cases that required

plastics input compared to 77% of cases where plastics were not required. Definitive fracture management within 72 hours

occurred in only 40% of cases that required plastics input compared to 81% in cases that did not. Infection was also recorded

in 42 % of cases where wound closure was delayed beyond 72 hours, compared to less than 3% of cases where the wound was

closed within the appropriate time period.

Conclusion

: Lack of an onsite plastics service can have a negative outcome on the management of open fractures especially in

relation to delayed wound closure and delayed fixation. We suggest that open fractures should only be managed in centres with

an on-site orthoplastic service.

Biography

Louai Abdeh is Trauma & Orthopedics Core Surgical Trainee at the Manchester Royal Infirmary. As a medical student and junior

doctor, he have taken an active role in many clinical governance and research projects, and he have presented at a number of

conferences including the ASiT International Conference 2018, Barts and London National Undergraduate Surgical Conference and

Warwick Undergraduate Regional Medical Conference. He have also completed a Master of Research in Tissue Engineering for

Regenerative Medicine, and he received a distinction grade for my dissertation “The Role of Macrophages and Mast Cells in Fibroblast

to Myofibroblast Differentiation- An insight into the Relationship between Inflammatory Cells and Fibrosis”.