Incidence of Surgical Site Infections and Acute Kidney Injuries After Topical Antibiotic Powder Application in Orthopaedic Trauma Surgery

Supratherapeutic Antibiotic Levels and Acute Kidney Injury from Absorption of Topical Antibiotics

“…Additional benefits have been shown to include decreased severity of heterotopic ossification in combat lower extremity amputations and increased bone regeneration 15,16 . Conversely, other studies have shown no decreased incidence of SSI with the use of topical vancomycin when controlled for fracture type 8,17 . A small number of spine surgery studies have suggested that the addition of Gram-negative coverage, such as the use of tobramycin, is required to reduce the SSI rate 11,18 .…”

Do Intrawound Antibiotics Reduce the Incidence of Surgical Site Infections in Pelvic and Lower-Limb Trauma Surgery? A Systematic Review and Meta-analysis

“…24 Five studies differentiated between deep and superficial SSIs in their reported outcomes. 17,19,20,22,23…”

“…Seven studies were qualitatively analyzed and included in the metaanalysis (see Table, Supplemental Digital Content 3, http://links.lww.com/JOT/B749). Six of the 7 included studies were retrospective case-control studies, [17][18][19][20][21][22] with the remaining study a randomized controlled trial. 23 Injuries investigated by the 7 studies included femoral shaft fractures, tibial plateau or pilon fractures, calcaneal fractures, pelvic ring injuries, and acetabular fractures (Table 1).…”

“…Multiple studies did not include superficial SSIs in analyses of the efficacy of intrawound antibiotics. 18,19,21,22 The definitions for superficial SSIs were not consistent across the studies that did provide data for this subset of infections. Cichos et al 17 defined SSIs as "positive bacterial cultures identified from samples acquired during irrigation and debridement" and further classified results into deep and superficial depending on the location of the infection relative to the fascia (infrafascial vs. suprafascial).…”

The Routine Use of Running Subcuticular Closures in Orthopaedic Trauma Patients Does Not Increase Wound Complications

“…Although the overall rate of deep SSI in this single surgeon series was high (9.3%), it was comparable with previously reported deep SSI rates in orthopaedic trauma procedures from the same institution (10.3% (41/396)). 26…”