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Tue Jun 5 23:39:26 BST 2012

Not really.
Only Zsolt Balogh and Manuel Sotelo responded to my original
query, which was a more general one..
My question this time around pertains to timing of open fracture
debridement/washout.
Wondering if any trauma centers incorporate that
into their quality assurance program.

On Wed, Jun 6, 2012 at 6:23 AM, Karim Brohi <karimbrohi at gmail.com> wrote:

> Caesar
> Didn't we answer this a couple of weeks ago??
> Karim
>
> On Mon, Jun 4, 2012 at 10:41 PM, Caesar Ursic <cmursic at gmail.com> wrote:
> > For almost as long as I can remember we tracked time to operative
> > debridement of severe open fractures as a quality measure
> > for Orthopaedic Trauma care.  This was based, I believe, on publications
> > back in the 1970s by Gustilo et al that showed higher infection rates
> with
> > delays beyond six hours.  Now recent papers based on series of 200-500
> > patients (and one meta-analysis) have concluded that the six hour rule
> > means nothing, and that these patients can be debrided and stabilized
> much
> > later after injury (as long as there is no significant vascular
> compromise
> > that requires immediate attention to correct limb ischemia).
> >
> > What does *your *trauma center's Trauma Quality Assurance (or whatever
> else
> > you call it -we call it "PIPS") program track?  Are you using some sort
> of
> > minimum time requirement or have you "moved on" to other metrics when it
> > come to assessing the quality of your Ortho Trauma care?
> >
> > Many thanks, etc,
> >
> > C. Ursic,
> > Honolulu
> > --
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High grade open extremity fractures: is the SIx Hour Rule totally obsolete?