Local Injection of Aminoglycosides for Prophylaxis Against Infection in Open Fractures

Abstract

This study suggests that local aqueous aminoglycoside administration as an adjunct to systemic antibiotics may be effective in lowering infection rates in open fractures; further research with higher-level research designs are needed.

Gentamicin coating of plasma chemical oxidized titanium alloy prevents implant-related osteomyelitis in rats

“…The optimal kinetics of antibiotic delivery from a carrier for prophylactic use is still unknown. In a recent study, Lawing et al used local injection of aminoglycosides to prevent infection in open fractures in the clinical setting [24]: Aminoglycosides were locally injected into the soft tissue without the use of a carrier. The rate of deep infection was reduced from 14.2 to 6.0% [24].…”

“…In a recent study, Lawing et al used local injection of aminoglycosides to prevent infection in open fractures in the clinical setting [24]: Aminoglycosides were locally injected into the soft tissue without the use of a carrier. The rate of deep infection was reduced from 14.2 to 6.0% [24]. This clinical finding, combined with the results from Lucke et al [15,16,23] and our results might suggest that local delivery of a high dose of aminoglycosides over a short period is effective in preventing implant-related infection.…”

Risk factors for infectious complications after open fractures; a systematic review and meta-analysis

“…Thirteen articles mentioned age as a risk factor, most reported mean age (N=10, 1,819 fractures), [8,[17][18][19][20][21][22][23][24][25] others median age (N=3, 1,477 fractures) [26][27][28]. Using those that presented age in means with standard deviations (SD) did not demonstrate significant differences between infected and non-infected patients.…”

“…Two studies included the ASA-score in their risk analysis, however, one used a mean number of points with standard deviation [25] and the other a cut-off point of 2 [24]. Neither found significant differences between the two groups.…”

Local Antibiotic Therapy for Osteomyelitis of a Replanted Hand

“…We washed out the soil thoroughly, but avascular tendons are easily inoculated with bacteria. Third, we could have injected prophylactic aminoglycoside at the time of the first surgery [5]. The incidence of infection of the wound in patients who have an open fracture correlates directly with the extent of soft tissue damage, classified as Gustilo-Anderson fracture type [6].…”