Purpose. To determine whether a change in prophylactic antibiotic protocol for orthopaedic surgeries may reduce the frequency of Clostridium difficile-associated diarrhoeal infections. wound infection. The frequency of C difficileassociated diarrhoeal infection decreased after use of the new antibiotic protocol (from 4 to 1%, p=0.004), particularly in the trauma patients (from 8 to 3%, p=0.02); in the elective patients the difference was not significant (from 1 to 0.5%, p=0.27). The change of antibiotic protocol did not significantly affect the incidence of deep wound infections in the trauma (p=0.46) or elective (p=0.90) patients. The rate of C difficile infection was 8-fold higher in the trauma than elective patients, both before and after the change of protocol. Conclusion. Changing antibiotic protocol is one way of reducing the incidence of C difficile-associated diarrhoeal infections in orthopaedic patients, without increasing the rate of deep wound infections.
Methods
Higher grade injuries (III-V) and intraparenchymal or subcapsular haematomas are associated with a higher failure rate of NOM ± AE and should be managed more aggressively. Grade I and II injuries can be discharged after 24 h with appropriate advice.
BackgroundManagement of pelvic fracture associated haemorrhage is often complex with high morbidity and mortality rates. Different treatment options are used to control bleeding with an on-going discussion in the trauma community regarding the best management algorithm.Main bodyRecent studies have shown trans-arterial embolisation (TAE) to be a safe and effective technique to control pelvic fracture associated haemorrhage. Computed tomography (CT) evidence of active bleeding, haemodynamic instability, and pelvic fracture patterns are amongst important indicators for TAE.ConclusionHerein, we aim to provide a comprehensive literature review of the effectiveness of TAE in controlling haemorrhage secondary to pelvic fracture according to the indications, technique and embolic agents, and outcomes, whilst incorporating our Level 1 major trauma centre’s (MTC) results between 2014-2017.Electronic supplementary materialThe online version of this article (10.1186/s42155-018-0031-3) contains supplementary material, which is available to authorized users.
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