TY  - JOUR
PY  - 2021//
TI  - Agricultural trauma causing open fractures: is antibiotic coverage against anaerobic organisms indicated?
JO  - Journal of Orthopaedic Trauma
A1  - Wynn, Malynda
A1  - Kesler, Kyle
A1  - Morellato, John
A1  - Higginbotham, Robert
A1  - Robertson, Michael
A1  - Marsh, J. L.
A1  - Hogue, Matthew
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: To compare deep infection rate and causative organisms in open fractures of the lower extremity from agricultural trauma to similar injuries in non-agricultural trauma. <br><br>DESIGN: Retrospective. SETTING: Two tertiary-care institutions. <br><br>METHODS: Open lower extremity fractures sustained between 2003-2018 by agriculture-related trauma in adult patients were reviewed. A non-agriculture open fracture control group was identified for comparison. Patient demographics and injury characteristics were assessed. Outcomes included occurrence of deep infection and causative organism. <br><br>RESULTS: 178 patients were identified in the agriculture(AG) (n=89) and control(NAG) (n=89) groups. Among agricultural-injury patients, farm machinery was the most common mechanism in 69 (77.5%) patients. Open injuries of the foot (38.2%) were most common in the AG-group and tibial shaft (25.8%) in the NAG-group.Deep infection was seen in 21% of the AG-group compared to 10% in the NAG-group(p<0.05). AG-group anaerobic infection occurred in 44% of patients with deep infection versus 9.1% in NAG-group(p<0.05). Most common anaerobic organisms included Enterococcus, Pseudomonas aeruginosa, and Clostridium perfringens. <br><br>CONCLUSION: This study supports that open fractures due to agricultural trauma have a high infection rate, with anaerobic infection occurring at higher rates than in non-agricultural trauma. Prophylactic treatment with antibiotics directed against anaerobes is indicated in these injuries. LEVEL OF EVIDENCE: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.<p />  <p>Language: en</p>
LA  - en
SN  - 0890-5339
UR  - http://dx.doi.org/10.1097/BOT.0000000000002192
ID  - ref1
ER  -