Risk factors for infection in patients with traumatic lacerations

Background: Most of our knowledge of laceration management comes from studi es in animal models or patients with closure of sterile postoperative surgi cal incisions. Traumatic laceration management has not been well studied. O bjective: To determine which characteristics of traumatic lacerations were associated with the development of wound infection. Methods: A cross-sectio nal study of consecutive patients with traumatic lacerations repaired over a four-year period was conducted. Structured closed-question data sheets we re prospectively completed at the time of laceration repair and suture remo val. Infection was determined at the time of suture removal. Multivariate m odeling was used to determine the adjusted odds ratio (OR) of infection. Re sults: Five thousand five hundred twenty-one patients were enrolled; 195 pa tients developed an infection (3.5%). An increased likelihood of wound infe ction was associated with age (adjusted OR per year, 1.01 95% CI = 1.0 to 1 .02); history of diabetes mellitus (adjusted OR 6.7; 95% CI = 1.7 to 26.4); laceration width (adjusted OR 1.05 per mm; 95% CI = 1.02 to 1.08); and pre sence of foreign body (adjusted OR 2.6; 95% CI = 1.3 to 5.2). Laceration lo cation on the head/neck was associated with a decreased risk of infection ( adjusted OR 0.28; 95% CI = 0.18 to 0.45). Conclusions: Both patient and wou nd characteristics of traumatic lacerations have an influence on the likeli hood of infection. This knowledge may be valuable for determining whether v arious methods of wound cleansing, debridement, and repair can improve the outcome of patients with traumatic lacerations.