A retrospective study of antibiotic prophylaxis value in surgical treatment of lower limb fracture

Bandalović, Ante; Zindović, Antonija; Boschi, Vladimir; Bakota, Bore; Marinović, Marin; Čoklo, Miran; Rošin, Matko; Parač, Zlatko; Čukelj, Fabijan

doi:10.1016/j.injury.2015.10.038

Cited by 6 publications

(6 citation statements)

References 18 publications

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“…Undoubtedly, the high‐energy mechanism and the resultant serious soft tissue damage, poor blood supply, and significant wound contamination contribute to a greater risk of SSI. In this study, the incidence of SSI following open fracture was 10.3%, about 3‐fold that (3.4%) of closed fractures ( P = 0.005), which is well within the reported literature . In a retrospective cohort of 39 patients with open fracture of distal femur treated by locking plates, 7 patients (incidence, 18%) developed SSIs, and it was also found that poor prognosis was directly related to the SSI .…”

Section: Discussionsupporting

confidence: 86%

“…In this study, the incidence of SSI following open fracture was 10.3%, about 3-fold that (3.4%) of closed fractures (P = 0.005), which is well within the reported literature. 6,10 In a retrospective cohort of 39 patients with open fracture of distal femur treated by locking plates, 7 patients (incidence, 18%) developed SSIs, and it was also found that poor prognosis was directly related to the SSI. 6 Therefore, in the presence of open fractures, surgeons should consult a heightened risk profile; early intravenous administration of antibiotics and adequate debridement should be compulsory.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and risk factors for surgical site infection after open reduction and internal fixation of intra‐articular fractures of distal femur: A multicentre study

Zhang²,

Cheng

et al. 2018

International Wound Journal

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There remains a lack of data on the epidemiological characteristics of surgical site infection (SSI) following the open reduction and internal fixation (ORIF) of intra‐articular fractures of distal femur, and the aim of this study was to solve this key clinical issue. The electronic medical records (EMRs) of patients who underwent ORIF for distal femoral fracture from January 2013 to December 2017 were reviewed to identify those who developed a SSI. Then, we conducted univariate Chi‐square analyses and used a multivariate logistic regression analysis model to determine the adjusted risk factors associated with SSI. A total of 724 patients who underwent ORIF of intra‐articular fractures of the distal femur were studied retrospectively, and 29 patients had postoperative SSIs. The overall incidence of SSIs was 4.0% (29/724), with deep SSIs being 1.5% (11/724), and superficial SSIs being 2.5% (18/724). Staphylococcus aureus was the most common causative pathogen (8, 42.1%), followed by mixed bacterial pathogens (5, 26.3%). Open fracture, obesity, smoking, and diabetes mellitus were identified as the adjusted risk factors associated with SSIs. Although modification of these risk factors may be difficult, patients and families should be counselled regarding their increased risk of SSI because these patients potentially benefit from focused perioperative medical optimisation.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for surgical site infection after open reduction and internal fixation of intra‐articular fractures of distal femur: A multicentre study

Zhang²,

Cheng

et al. 2018

International Wound Journal

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“…Our 16% (12% femoral and 35% tibial) prevalence of SSI is higher than reported in most studies from richer countries, 9,22,25,[35][36][37]41 where it is generally < 2%. 38 Several factors may be relevant; all participants had delays before fracture fixation by open reduction and IMN, both of which are known risk factors for SSI, in contrast to standard early fracture fixation by closed reduction and IMN.…”

Section: Discussioncontrasting

confidence: 57%

Prognostic factors for surgical site infection following intramedullary nailing of diaphyseal fractures of the femur and tibia in adult patients at a tertiary hospital in Lusaka, Zambia

et al. 2021

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Our study aimed to identify prognostic factors for surgical site infection following long bone fracture intramedullary nailing at a tertiary hospital in a low-resource setting. This was a longitudinal observational study involving 132 participants enrolled over a one-year period with femoral and tibial diaphyseal fractures scheduled for ORIF. Participant median age was 30 years (range: 26 – 42). The prevalence of surgical site infection was 16%. Male sex (AOR=0.26, 95% CI [0.70–0.98]; p = 0.047) was associated with lower odds of surgical site infection while associated non-musculoskeletal injuries were associated with higher odds of developing surgical site infection. Our study confirms a higher surgical site infection rate than normally accepted. However, intramedullary nailing in our setting is justified as it allows an early return to a pre-injury state. These interventions must be carried out in the best possible circumstances. Future studies could explore alternative methods of fracture fixation.

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“…Faktor endogen paling besar adalah bakteri dari kulit, membran mukosa atau rongga dalam (Bandalović et al, 2015). Bakteri yang paling banyak ditemukan penyebab IDO pada bedah ortopedi diantaranya adalah Staphylococcus aureus, coagulase-negative staphylococci, dan bakteri gram negatif (Li et al, 2013).…”

Section: Pendahuluanunclassified

“…Pemilihan antibiotik profilaksis yang tepat dapat melindungi pasien dari infeksi pasca operasi dengan mengurangi kemungkinan jumlah bakteri yang menginfeksi dari pasien maupun lingkungan ruang bedah pada saat operasi (Najjar & Smink, 2015). Sefalosporin merupakan jenis antibiotik yang paling umum diresepkan karena merupakan antibiotik spektrum luas yang efektif sebagai anti Staphylococcus, memiliki profil farmakokinetik yang baik, angka kejadian efek samping yang kecil, serta harga yang relatif murah (Bandalović et al, 2015). Pada kasus bedah ortopedi, sefalosporin generasi pertama seperti cefazolin atau generasi kedua seperti cefuroxime merupakan pilihan yang direkomendasikan (Trampuz & Widmer, 2006).…”

Section: Pendahuluanunclassified

Perbandingan Efektivitas Cefazolin dan Ceftriaxone Sebagai Antibiotik Profilaksis Bedah Ortopedi Open Reduction Internal Fixation (ORIF) Fraktur Tertutup

Latifah

Andayani

Ikawati

2021

J. Pharm. Sci. Clin. Res.

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Infeksi daerah operasi (IDO) merupakan infeksi yang terjadi hingga 30 hari setelah operasi atau satu tahun setelah operasi pada pasien yang menerima implan dan mempengaruhi sayatan atau jaringan dalam di lokasi operasi. Sefalosporin golongan pertama yaitu cefazolin merupakan antibiotik pilihan sebagai proflaksis bedah karena merupakan antibiotik spektrum luas, memiliki profil farmakokinetik yang baik, angka kejadian efek samping yang kecil, serta harga relatif murah. Pada praktek klinis, ceftriaxone banyak digunakan karena merupakan antibiotik yang lebih murah dibanding cefazolin. Tujuan penelitian ini adalah untuk mengetahui efektivitas dan keamanan cefazolin dibandingkan dengan ceftriaxone sebagai antibiotik profilaksis pasien bedah ortopedi Open Reduction Internal Fixation (ORIF) fraktur tertutup. Penelitian ini merupakan penelitian observasional analitik dengan rancangan kohort retrospektif dari rekam medis pasien yang menjalani ORIF fraktur tertutup periode 1 Januari hingga 31 Desember 2020 di sebuah rumah sakit swasta tipe B di Yogyakarta. Luaran klinis yang diamati dalam penelitian ini adalah kejadian IDO dan kejadian efek samping selama 90 hari sejak pasien dilakukan prosedur bedah. Terdapat 59 pasien yang menjalani ORIF yang masuk kriteria inklusi pada penelitian ini yang terbagi mejadi dua kelompok yaitu pasien yang mendapat antibiotik profilaksis cefazolin (n=25) dan ceftriaxone (n=34). Hasil dari penelitian ini menunjukkan bahwa angka kejadian IDO pada pasien yang menjalani ORIF fraktur tertutup sebesar 5,08% dari total subjek atau 8,82% dari yang diberikan ceftriaxone dan 0% dari pasien yang diberikan cefazolin. Perbedaan probabilitas kejadian IDO pada pemberian ceftriaxone sebagai antibiotik profilaksis tidak berbeda bermakna dengan pemberian cefazolin (RR = 1,097; 95% CI = 0,988 – 1,218; p = 0,064).

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A retrospective study of antibiotic prophylaxis value in surgical treatment of lower limb fracture

Cited by 6 publications

References 18 publications

Incidence and risk factors for surgical site infection after open reduction and internal fixation of intra‐articular fractures of distal femur: A multicentre study

Incidence and risk factors for surgical site infection after open reduction and internal fixation of intra‐articular fractures of distal femur: A multicentre study

Prognostic factors for surgical site infection following intramedullary nailing of diaphyseal fractures of the femur and tibia in adult patients at a tertiary hospital in Lusaka, Zambia

Perbandingan Efektivitas Cefazolin dan Ceftriaxone Sebagai Antibiotik Profilaksis Bedah Ortopedi Open Reduction Internal Fixation (ORIF) Fraktur Tertutup

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