Abstract
Published infection rates following wounds sustained in combat vary dramatically. We reviewed UK military extremity trauma, sustained in Afghanistan over a two year period, to evaluate early infection rates and causative organisms. Data on wound site, time to onset of infection, organisms detected and method of presentation were collected.
351 patients had full datasets for clinical wound surveillance and microbiological data. 58 (16.5%) patients were diagnosed with wound infections. Median time to diagnosis was 17 days (range = 749, Interquartile range =31.75 days). Limb infection was detected in 53 (15.1%) patients. Infection was statistically significantly more likely to be incurred in the lower extremity (p=0.0220). Multiple organisms were identified in 34 (64.2%) of the 53 patients with a limb infection. Fungi were significantly more common in early presenters (<30 days after injury) (p=0.0024). Staphylococcus aureus was significantly more likely in late presentation (p=0.002). Infection was more likely in those injured by an improvised explosive device (p=0.0019).
The overall infection rates recorded are low when compared to historical data. Organisms isolated from infected wounds are frequently multiple. The microbial spectrum and the number of organisms present on diagnosis change with time from wounding.
