Abstract：
BACKGROUND:The fields of surgery and trauma care have largely been neglected in the global health discussion. As a result the idea that surgery is not safe or cost effective in resource-limited settings has gone unchallenged. The SIGN Online Surgical Database (SOSD) is now one of the largest databases on trauma surgery in low- and middle-income countries (LMIC). We wished to examine infection rates and risk factors for infection after IM nail operations in LMIC using this data. METHODS:The SOSD contained 46,722 IM nail surgeries in 58 different LMIC; 46,113 IM nail operations were included for analysis. RESULTS:The overall follow-up rate was 23.1 %. The overall infection rate was 1.0 %, 0.7 % for humerus, 0.8 % for femur, and 1.5 % for tibia fractures. If only nails with registered follow-up (n = 10,684) were included in analyses, infection rates were 2.9 % for humerus, 3.2 % for femur, and 6.9 % for tibia fractures. Prophylactic antibiotics reduced the risk of infection by 29 %. Operations for non-union had a doubled risk of infection. Risk of infection was reduced with increasing income level of the country. CONCLUSIONS:The overall infection rates were low, and well within acceptable levels, suggesting that it is safe to do IM nailing in low-income countries. The fact that operations for non-union have twice the risk of infection compared to primary fracture surgery further supports the use of IM nailing as the primary treatment for femur fractures in LMIC.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Young S,Lie SA,Hallan G,Zirkle LG,Engesæter LB,Havelin LIdoi
10.1007/s00268-012-1817-4subject
Has Abstractpub_date
2013-02-01 00:00:00pages
349-55issue
2eissn
0364-2313issn
1432-2323journal_volume
37pub_type
杂志文章abstract：IMPORTANCE:In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. OBJECTIVE:To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital sign...
journal_title：World journal of surgery
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更新日期：1993-11-01 00:00:00
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