The Novel Role of Healing from Bacterial Infections of Lower Limb Open Fractures by X-Ray Exposure

Abstract EN

Introduction.

An open fracture refers to a break in the skin, which is exposed to microbial contamination and eventually leads to most complicated infections.

X-rays can kill bacteria by causing irreversible DNA damage.

Objective.

To confirm the role of X-ray exposure in treating infected wound fractures at the lower limb and determine X-ray exposure times.

Methods.

Fifty-one wound swabs were collected from patients with infected open fractures at the lower limb with grade II, IIIA, B, and C according to the Gustilo and Anderson classification system and then cultured.

The bacterial isolates were identified by biochemical tests and the VITEK-2 System and tested against several antibiotics.

The X-ray exposure was done for open fractures by radiography (at kV133 and 5 milliambers).

Results.

The higher isolation rate was recorded for Staphylococcus aureus with 21 (41.2%) isolates, and most of them (20, 95.2%) were isolated from grade II fractures.

The isolation rate of Gram-negative bacteria was 25.5% for Escherichia coli with 13 isolates, 19.6% for Pseudomonas aeruginosa with 10 isolates, and 13.7% for Klebsiella pneumoniae with 7 isolates, most of which were isolated from grade III fractures.

The isolation rate of P.

aeruginosa was 60% (6 isolates) from grade IIIA and 71.4% (5 isolates) from grade IIIB for K.

pneumoniae, while for E.

coli it was 69.2% (9 isolates) from grade IIIC.

All the bacterial isolates recorded high levels of antibiotic resistance against most tested antibiotics.

Wound cultures of grade II fractures appeared sterile after the first X-ray exposure, and these wounds were infected with S.

aureus or P.

aeruginosa.

However, cultures of grade IIIA and IIIB fractures appeared sterile after the second X-ray exposure for all isolated bacteria, except for S.

aureus (grade IIIA fractures) (after the third X-ray exposure).

Grade IIIC fractures showed sterile culture after the third X-ray exposure for wounds infected with P.

aeruginosa and E.

coli.

Conclusions.

The study concluded that X-ray exposure showed high effectiveness in treating infected open fractures.