The Open fracture National Evaluation (ONE) Study - South Africa: Improving outcomes in the care of open fractures in low resource settings

地面伤害是10-49岁人群死亡的主要原因。更多的人死于伤害，而不是艾滋病毒，疟疾和结核病的总和。每有一个人死亡，就有多达50人幸存下来，但成为残疾人。开放性骨折是最具破坏性的MSK损伤类型之一。开放性骨折是一种骨折，其中部分骨头通过皮肤出来，可能导致灾难性的后果，包括高感染率和截肢。它们最常影响生活在世界各地贫困地区的人们，如非洲国家。目前尚不清楚非洲有多少人患有开放性骨折，有哪些医疗服务可以治疗他们，以及如何最好地改善他们的康复。如果没有这些基本的信息，就很难知道如何在资源有限的情况下改善这些复杂损伤的护理。AIMTo improve the outcome of open fractions in low resource settings.Location这个项目将在南非的多家医院进行。评估现有治疗开放性骨折的医疗资源（设施、设备和人员）2.确定南非受开放性骨折影响的人数3。评估进行大规模临床研究的可行性，其目标是改善在低资源环境中经历开放性骨折的患者的恢复。定义可用于治疗开放性骨折的医疗资源：我将描述目前可用于治疗南非开放性骨折的医疗资源。工作包2.确定问题的大小：我将与南非各地的合作医院网络合作，以确定开放性骨折的发生率。工作包3：实施多医院可行性研究：通过我的合作医院网络，我将进行一项多医院研究，以“测试”是否有可能对开放性骨折患者进行大规模的研究。影响我的研究将从三个方面影响患者的护理：1.通过了解当前的治疗服务可用性，医疗保健管理人员将能够识别和填补服务准备就绪方面的差距。通过了解医疗中心开放性骨折的数量和类型，临床医生将能够更好地分配开放性骨折管理的资源。3.通过“测试”开放性骨折护理的大规模研究是否可行，临床医生将为未来的全国性研究建立当地的研究能力和基础设施，以改善低源环境下开放性骨折患者的护理。总之，该项目将提供关键信息，帮助当地医护人员和政策制定者规划未来开放性骨折护理的提供。鉴于目前有限的证据，如果没有这项工作，发展中国家对这些复杂损伤的护理不太可能得到改善。

BACKGROUNDInjuries are the leading cause of death in people aged between 10-49 years. More people die from injuries than from HIV, malaria, and tuberculosis combined. For every person who dies, up to 50 people survive but become disabled. Open fractures are amongst the most devastating type of MSK injury. An open fracture is a break of a bone where part of the bone comes out through the skin and can result in catastrophic consequences, including high rates of infection and amputation. They most commonly affect people living in poor regions around the world, such as countries in Africa. It is not known how many people in Africa sustain an open fracture, what healthcare services are available to treat them or how best to improve their recovery. Without this fundamental information, it is difficult to know how to improve the care of these complex injuries in resource limited settings.AIMTo improve the outcomes of open fractures in low resource settings.LOCATION This project will be undertaken across multiple hospitals in South Africa.OBJECTIVES1. Assess current healthcare resources (facilities, equipment, and people) that exist to treat open fractures 2. Determine the number of people affected by an open fracture across South Africa3. Assess the feasibility to undertake a large-scale clinical study, with the goal of improving the recovery of patients who have experienced an open fracture in a low resource environmentMETHODSObjectives will be answered through four connect project work packages;Work Package 1. Define the healthcare resources available for the treatment of open fractures: I will describe the healthcare resources currently available to treat open fractures across South Africa. Work Package 2. Determine the size of the problem: I will work with a network of collaborating hospitals throughout South Africa to determine how commonly open fractures occur. Work Package 3: Implement a multi-hospital feasibility study: Through my network of collaborating hospitals, I will undertake a multi-hospital study to 'test' if it is possible to do large-scale research studies of patients suffering from an open fracture.IMPACTMy research will impact the care of patients in three ways;1. By understanding current treatment service availability, healthcare managers will be able to identify and fill gaps in service readiness.2. By knowing the number and type of open fractures presenting to their healthcare centre, clinicians will be able to better allocate resources for open fracture management. 3. By 'testing' if it is possible to do a large-scale research study in open fracture care, clinicians will build the local research capacity and infrastructure for a future nationwide study to improve the care of patients suffering open fractures in low source settings.In summary, this project will provide key information to help local healthcare workers and policy makers plan future delivery of open fracture care. Without this work it is unlikely, given current limited evidence, that the care of these complex injuries in developing countries will improve.