Description
In this presentation by Dan Deakin, the audience is invited to engage in an interactive discussion about recent efforts in Nottingham to enhance the outcomes of open tibial fractures. Deakin reflects on the challenges faced since the reissuance of open fracture guidelines in 2017, highlighting the difficulty of assessing infection rates and treatment efficacy within their hospital. He initiated a comprehensive audit in 2017 to track every open tibial fracture treated at their major trauma center, collecting data over the following years to evaluate treatment methods and associated infection rates.
Through the audit, it was revealed that while the hospital performed an average of 60 open tibial fractures annually, the infection rates were concerning, particularly regarding the treatment of simple fractures compared to more complex cases. To address this, a combined meeting with consultants from orthopedic and plastic surgical specialties was arranged outside the hospital setting to foster collaboration and create a consensus statement aimed at standardizing surgical treatment approaches. Key agreements were reached on the necessity of consultant involvement in initial debridement and the importance of avoiding undertreatment in seemingly simple fractures.
The follow-up audit demonstrated improved consultant engagement during surgeries, resulting in a decline in deep infection rates. Deakin emphasizes the value of continuous prospective audits, collaboration between specialties, and the impact of fostering personal relationships among surgeons to improve patient care outcomes. He concludes by encouraging the pursuit of consensus statements to guide practice and facilitate adherence to agreed treatment protocols.