Infection Rate in Patients with Compound Depressed Skull Fractures and Primary Bone Fragment Replacement, Kashan-Iran, 1997-2005

Compound depressed skull fracture (CDF) is a complication of trauma to head. In spite of many decades of studies on the management of CDF there is yet disagreements regarding primary repair or discarding the bone fragments and late repair. This study has conducted to evaluate infection rate in primary repair of CDF. This study included 60 patients with blunt trauma to head and CDF admitted to Naghavi hospital of Kashan University of Medical Sciences (KAUMS), from 1997 to 2005. Age, sex, the interval between admission and operation, severity of trauma, duration of hospital stay, and infections were recorded and analyzed with descriptive statistics. Male to female ratio was 7.6:1, and mean age 19±12.4 years. It was most common in the age range of 11-20 (19 patients, 31.7%). Motorcycle was the most common cause of the problem (45 patients, 75%). Tirty nine patients (65%) had dural laceration. The most common site of fracture was frontal bone (37 and 61.7%). Twenty eight cases (46.6%) had mild, 13 (21.7%) moderate, and 19 (31.7%) severe head injury. Fifty four patients (90%) underwent operation in less than 24 hours of their arrival to hospital and had primary bone replacement. In 6 months follow up there was no infection in either the wound or bone. In the absence of heavy contamination, and by carrying debridment as soon as possible there will be excellent outcome with primary replacement of bone fragments in CDF patients, excluding the need for another operation and the apprehension about infection.