AB108. SOH23ABS_036. Open to change: can district general hospitals deal with open fractures too?

Background: Fractures compromising soft tissues puts patients at risk of significant morbidity, therefore require timely multidisciplinary management. The British Orthopaedic Association Standard for Trauma (BOAST) Guidelines, updated December 2017, state “Patients with open fractures of long bones, hind foot or midfoot should be taken directly or transferred to a specialist centre that can provide orthoplastic care”. Northern Ireland’s population is estimated at 1.8 million, within this there are between 370 and 500 cases of major trauma each year.

Methods: This review looks at patients presenting to Craigavon Area Hospital in Northern Ireland, between October 2021 to October 2022, with open fractures.

Results: Over the study period, 41 Open fractures presented, 12 meeting criteria for transfer to a major trauma centre with orthoplastic’s present as per BOAST Guidelines point 1. However, 11 patients were managed in Craigavon Area Hospital and 1 patient required transfer to a site with plastics available.

Conclusions: Can we learn from this same subgroup of patients? There is an ever-growing demand to major trauma centres in Northern Ireland some of the burden on which can be dealt with by district general hospitals (DGH)’s. This data should help contribute to any future updates of BOAST’s guidelines.

Keywords: British Orthopaedic Association Standard for Trauma (BOAST); fracture; guidelines; open; Northern Ireland