Assessment of current practice of open fracture management in hospitals of Malawi
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Date
21-09-15
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Publisher
Kamuzu University of Health Sciences
Abstract
EXECUTIVE SUMMARY
Type of research study: Quantitative descriptive retrospective and prospective study design.
The problem:Open fractures are a common consequence of road traffic accidents and are
associated with a high risk of complications. The introduction of standards guidelines in other
countries have proven to reduce the risk of complications of open fractures. There are plans
to introduce in Malawi the validated guidelines by September 2021“Malawi Orthopaedic
Association/Arbeitsgemeinschaft Fur Osteosynthesefragen Alliance (MOA/AO Alliance)
guidelines for open fracture management”, however there is inadequate data on the current
practice of open fracture management in the hospitals of Malawi to see whether they are
compliant with the validated Malawi Orthopaedic Association/Arbeitsgemeinschaft Fur
Osteosynthesefragen Alliance open fracture management guidelines, hence a need to do this
study before the introduction and immediately afterwards.
Main objective
To assess the management of open fractures in hospitals of Malawi before and immediately
after the implementation of guidelines
Specific objectives
To measure the management of open fractures before and after the implementation of
guidelines in casualty, theater and wards
To explore time of referral for severe open fractures to higher referral centres
To describe the documentation of the whole assessment and management of open fracture
in medical records
To capture the hospital immediate complications of open fractures like local wound
infection, compartment syndrome and amputation
Methodology: This is a quantitative descriptive retrospective and prospective study which
will recruit participants with open fractures presenting to Zomba central hospital, Mulanje
district hospital, Salima district hospital, and Mangochi district hospital over a 6-month
period. Data clerks in each center will be trained to collect high quality data using a standard
data capture forms. The data collected will include demographic details, mechanism of injury,
diagnosis, treatment details and hospital complications from the patient’s medical files and
trauma register book. Descriptive statistics will be used to compare before and after the
Malawi Orthopaedic Association/Arbeitsgemeinschaft Fur Osteosynthesefragen Alliance
open fracture management guidelines training course (adjusted for confounders including age
and gender). The study will not collect any names and patients will be fully anonymised.
Expected findings and dissemination: Results will describe the management of open fracture
in hospitals of Malawi before and after implementation of the Malawi Orthopaedic
Association/Arbeitsgemeinschaft Fur Osteosynthesefragen Alliance guidelines. The results
will be presented to the management team in all participating hospitals, Research
Dissemination day at Kamuzu University of Health Sciences, Malawi Orthopaedic
Association annual scientific conference, College of Surgeons of East, Central and Southern
Africa (COSECSA) annual scientific meeting and AO Alliance Foundation, an organization
that developed the guidelines. The full report will also be submitted to College of Medicine
Research and Ethics committee. An article may be submitted to a peer reviewed journal for
publication
Description
Keywords
Open fracture management