Antibiotics in Human Hematoma and Wound Fluid

Nelson, Carl L.; Bergfeld, John A.; Schwartz, Jonina; Kolczun, Michael C.

doi:10.1097/00003086-197505000-00021

Cited by 15 publications

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“…The effectiveness of antibiotics in prevention of drainpotentiated wound infections should be questioned because not all antibiotics can effectively penetrate hematoma and wound fluid [85]. If an antibiotic penetrates the wound being drained, its concentration is lower than the serum concentration and may be below the minimum inhibitory concentration [85].…”

Section: Antibiotics For Wound Drainage and Drainsmentioning

confidence: 99%

“…If an antibiotic penetrates the wound being drained, its concentration is lower than the serum concentration and may be below the minimum inhibitory concentration [85]. In addition, several studies suggest prolonged use of postoperative antibiotics may actually increase infection rates [78,127] and promote antibiotic resistance [56].…”

Section: Antibiotics For Wound Drainage and Drainsmentioning

confidence: 99%

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Myths and Legends in Orthopaedic Practice: Are We All Guilty?

Tejwani

Immerman

2008

Clinical Orthopaedics &Amp; Related Research

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Over years of practice, many beliefs and practices become entrenched as tried and tested, and we subconsciously believe they are based on scientific evidence. We identified nine such beliefs by interviewing orthopaedic surgeons in which studies (or lack thereof) apparently do not support such practices. These are: changing the scalpel blade after the skin incision to limit contamination; bending the patient's knee when applying a thigh tourniquet; bed rest for treatment of deep vein thrombosis; antibiotics in irrigation solution; routine use of hip precautions; routine use of antibiotics for the duration of wound drains; routine removal of hardware in children; correlation between operative time and infection; and not changing dressings on the floor before scrubbing. A survey of 186 practicing orthopaedic surgeons in academic and community settings was performed to assess their routine practice patterns. We present the results of the survey along with an in-depth literature review of these topics. Most surgeon practices are based on a combination of knowledge gained during training, reading the literature, and personal experience. The results of this survey hopefully will raise the awareness of the selected literature for common practices.

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Section: Antibiotics For Wound Drainage and Drainsmentioning

confidence: 99%

Section: Antibiotics For Wound Drainage and Drainsmentioning

confidence: 99%

Myths and Legends in Orthopaedic Practice: Are We All Guilty?

Tejwani

Immerman

2008

Clinical Orthopaedics &Amp; Related Research

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Effect of irrigation and tourniquet application on aminoglycoside antibiotic concentrations in bone

Millan

Petty

Hendeles

1988

Journal Orthopaedic Research

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Preoperative antibiotics are an important measure taken to prevent infection in joint replacement surgery. The local availability of these antibiotics in the operative site is absolutely necessary to ensure adequate prophylaxis against contaminant bacteria. Because pulsatile-lavage rapid-recovery systems have become a routine technique of bone preparation in joint reconstruction, we chose to study the effect of these systems on local antibiotic concentrations. We further investigated the effect of irrigation with and without use of a limb tourniquet. For our study, we obtained 23 bone specimens in 16 patients undergoing joint reconstruction (14) or amputation (2). The patients were classified into one of four groups based on whether a tourniquet was applied during the procedure and whether the bone specimens were irrigated. In addition, matched blood samples were obtained to establish that therapeutic serum levels were achieved. Nine patients contributed 13 bone specimens, which underwent vigorous irrigation in vitro. None of these specimens had detectable levels of antibiotics, regardless of whether a tourniquet was used. Seven patients yielded 10 bone specimens, which were not irrigated. Five of these seven patients had detectable levels of antibiotics. In addition, the specimens from limbs without tourniquets had levels that averaged 0.51 microgram/ml while those with tourniquets averaged below 0.2 microgram/ml. Therefore, the use of vigorous irrigation in bone preparation has a significant deleterious effect on the local presence of previously administered systemic antibiotics. This effect is compounded if the operative site is isolated from continuous blood flow by use of a tourniquet. We therefore recommend that additional measures be taken to ensure that adequate antibiotic levels are present.(ABSTRACT TRUNCATED AT 250 WORDS)

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Postoperative Komplikationen

Jerosch¹

2015

Knieendoprothetik

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Antibiotics in Human Hematoma and Wound Fluid

Cited by 15 publications

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Myths and Legends in Orthopaedic Practice: Are We All Guilty?

Myths and Legends in Orthopaedic Practice: Are We All Guilty?

Effect of irrigation and tourniquet application on aminoglycoside antibiotic concentrations in bone

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