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Review Question - QID 211606

QID 211606 (Type "211606" in App Search)
Figure 1 is the clinical photograph of a 41-year-old male who presented to the ED at 11 PM, 3 hours following a rural zip lining accident. The patient was transferred by personal car from the scene. Within 30 minutes of his arrival to the hospital the patient was given IV antibiotics and the leg was splinted. The following morning the patient was taken to the OR for irrigation, debridement and reamed intramedullary nailing of this injury. A negative pressure dressing was initially utilized over the open wound and definitive closure was performed on hospital day 3. In this scenario, which of the following is independently linked to this patient's increased risk of infection?
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