Incidence of Infection among Patients Presented with Open Fractures due to Gunshot in Dongola Military Hospital (2023 - 2025)

Abstract

Background: War is a devastating event that not only affects lives but also leaves a lasting impact on the healthcare system. One such conflict occurred in Sudan, starting on 15 th April 2023, in Khartoum State and other states. The war resulted in a high burden of injuries, particularly gunshots, among both military personnel and civilians. Open fractures resulting from gunshot wounds are severe injuries that require immediate medical attention. These injuries not only pose a high risk of bone damage but also carry a significant risk of wound infection. Wound infections in these cases can lead to detrimental consequences such as extended hospital stays, increased healthcare costs, prolonged recovery, and, in severe cases, even amputation (1).Traumatic injuries, particularly open fractures, are a leading cause of morbidity and mortality. Early medical intervention, infection control, and proper treatment strategies are critical for improving patient outcomes. This study aimed to investigate the demographic characteristics, clinical profiles, and treatment gaps in patients with traumatic injuries, with a focus on injury patterns, medical presentation times, and complications. Methods: This is a cross-sectional study conducted on 138 patients presenting with traumatic injuries at Dongola Military Hospital, located in Dongola city . Demographic data, clinical profiles, injury-related factors, and complications were collected. The study also examined diagnostic trends, including imaging and microbiological tests, as well as blood test results. Results: Most participants were male (92%) and younger than 40 years (65.2%). Hypertension (48.6%) and diabetes (38.4%) were common comorbidities. Most injuries affected the lower limbs (71.7%), with the majority classified as severe (Gustilo-Anderson Type III). Contaminated injuries were common (88.4%), and 42.8% of patients experienced wound infections. Early presentation (within 24 hours) occurred in 60.1% of patients, but only 25.4% received antibiotics within 3 hours. Elevated inflammatory markers (WBC, CRP, ESR) were observed in most cases. Conclusions: Delayed medical presentation, late antibiotic administration, and high contamination rates highlight significant gaps in trauma care. The study emphasizes the importance of early intervention, strict infection control, and timely surgical management. Enhancing pre-hospital care, improving diagnostic capabilities, and strengthening multidisciplinary care could improve outcomes.