Infection in compound depressed fracture of the skull.

OBJECTIVE

To find out the association of wound infection with dural tear, free bone fragments and late presentation in patients operated for compound depressed fracture of the skull.

DESIGN

Descriptive study.

PLACE AND DURATION OF STUDY

This study was conducted in the Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad from January 2002 to December 2002.

SUBJECTS AND METHODS

There were 56 patients with compound depressed fracture of the skull, who were operated in the department. Their clinical, radiological and operative findings were studied. The postoperative condition of the wound was noted. The patients were followed up for six months. All of them were given antibiotics. The mode of trauma, time of arrival and site of fracture were noted. The mean age, male to female ratio and rate of postoperative wound infection were determined.

RESULTS

Among the 56 patients operated for compound depressed fracture, there were 30 adults and 26 children. Male to female ratio was 4.6:1. Mean age was 21.7 years. Major mode of trauma in children was fall, while most of the adult patients presented with history of assault and RTA. There were 71.42% fractures in frontal and parietal regions. Three patients (5.35%) got wound infection postoperatively.

CONCLUSION

Dural tear, free bone fragments and late presentation (more than 8 hours after trauma) were the important risk factors. Early surgery and proper debridement with antibiotic cover play an important role in reducing the rate of wound infection.