Surgical site infection in high-energy peri-articular tibia fractures with intra-wound vancomycin powder: a retrospective pilot studyReportar como inadecuado

Surgical site infection in high-energy peri-articular tibia fractures with intra-wound vancomycin powder: a retrospective pilot study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal of Orthopaedics and Traumatology

, Volume 16, Issue 4, pp 287–291

First Online: 10 May 2015Received: 20 December 2014Accepted: 23 April 2015


BackgroundSurgical site infections SSI continue to be a significant source of morbidity despite the introduction of perioperative intravenous antibiotics. Our objective was to assess the efficacy of local vancomycin powder on lowering deep SSI rates in high-energy tibial plateau and pilon fractures.

Materials and methodsA retrospective review of all tibial plateau and pilon fractures treated in 2012 at our level I trauma center identified 222 patients. Of these, 107 patients sustained high-energy injuries that required staged fixation, and 93 had minimum 6 month follow-up. Ten patients received 1 gram vancomycin powder directly into the surgical wound at the time of definitive fixation, and the remaining 83 patients served as controls. SSI was defined according to criteria from the Centers for Disease Control. Demographic data, patient comorbidities, injury and treatment details, and infection details were recorded. Descriptive and comparative statistics were performed.

ResultsAmongst the vancomycin powder group, 1 patient 10 % developed a deep SSI; in the control group, 14 16.7 % developed deep SSI. The rate of deep SSI between the groups was not statistically significantly different P = 1.0. The groups were statistically similar with regard to injuries, treatment, comorbidities, and infectious outcomes P values range = 0.06–1.0.

ConclusionsThe application of local vancomycin powder into surgical wounds of high-energy tibial plateau and pilon fractures did not reduce the rate of deep SSI in this retrospective review. There is a need to find effective, cheap, and widely available methods for prevention of SSI. Basic science and larger prospective clinical studies are needed to further delineate the role of local vancomycin powder as a modality to reduce deep SSI in extremity trauma.

Level of evidence Level III, therapeutic.

KeywordsTibial plateau Tibial plafond Pilon Vancomycin powder Infection  Download fulltext PDF

Autor: Keerat Singh - Jennifer M. Bauer - Gregory Y. LaChaud - Jesse E. Bible - Hassan R. Mir


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