Salvage of rib stabilization hardware with antibiotic beads

Junker, Michelle S.; Kurjatko, Alex; Hernandez, Matthew C.; Heller, Stephanie F.; Kim, Brian D.; Schiller, Henry J.

doi:10.1016/j.amjsurg.2019.02.032

Cited by 14 publications

(21 citation statements)

References 19 publications

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“…Junker et al identified increased body mass index and hemorrhagic shock at admission as risk factors for infection. 10 We agree with the management algorithm proposed by Thiels et al: in case of suspicion of superficial wound infection (e.g., purulent discharge and wound dehiscence), a prompt surgical exploration and debridement are warranted. Negative pressure dressings could be used for a second-intention healing.…”

Section: Discussionsupporting

confidence: 85%

“…[6][7][8] As surgical fixation for rib fractures starts to gain wide acceptance, surgeons must be aware of the potential risk of infection involving the hardware. 1,4,10 However, its incidence is difficult to estimate and its treatment is not well standardized due to the lack of robust data. 1 There are few case series that advocate this issue.…”

Section: Discussionmentioning

confidence: 99%

“…5 In a case series of 285 operated patients reported by Junker et al, the infection rate was 3.5% and the use of antibiotic beads yielded excellent results. 10 As stressed by Lu and Hansen, even though the gold standard is hardware removal along with all necrotic tissue, aggressive irrigation and debridement could control the infection during the acute phase. 5 According to Thiels et al, rib fixation material is prone to infection as rib fractures usually communicate with the airways via lung lacerations or with the external environment via chest tubes.…”

Section: Discussionmentioning

confidence: 99%

“…1,4 However, it seems to be quite rare. 1,4,9,10 The aim of the study is to share our experience in the management of infection involving material after surgical rib fixation for blunt trauma and to stress the need of designing surgical databases to enhance the existing evidence.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Single-Center Experience of Osteosynthesis Material Infection after Rib Fixation for Blunt Trauma

Agrafiotis

Etienne

Roux

et al. 2020

Thorac Cardiovasc Surg

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Introduction There is no data regarding the incidence and treatment of deep infection affecting the surgical implants after rib fixation. The aim of this study is to share our experience in the management of infected material after surgical rib fixation. Methods The medical records of operated patients from January 2012 to December 2018 were retrospectively analyzed. Results Three patients out of 87 (3.44%) developed an infection. One patient was treated conservatively and two patients were operated for hardware removal. Conclusions The lack of evidence prompts for the design of surgical databases to share experience and enhance available data.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Single-Center Experience of Osteosynthesis Material Infection after Rib Fixation for Blunt Trauma

Agrafiotis

Etienne

Roux

et al. 2020

Thorac Cardiovasc Surg

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“…Fourteen fracture studies were included, with three RCTs, two prospective observational studies, and nine retrospective studies (Table 2) [50][51][52][53][54][55][56][57][58][59][60][61][62][63]. A total of 4,635 patients were included.…”

Section: Fracture Repairmentioning

confidence: 99%

Prophylactic Topical Antibiotics in Fracture Repair and Spinal Fusion

Kim

Donnelley

Tiee

et al. 2021

Advances in Orthopedics

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Introduction. The objective of this systematic review with meta-analysis is to determine whether prophylactic local antibiotics prevent surgical site infections (SSIs) in instrumented spinal fusions and traumatic fracture repair. A secondary objective is to investigate the effect of vancomycin, a common local antibiotic of choice, on the microbiology of SSIs. Methods. An electronic search of PubMed, EMBASE, and Web of Science databases and major orthopedic surgery conferences was conducted to identify studies that (1) were instrumented spinal fusions or fracture repair and (2) had a treatment group that received prophylactic local antibiotics. Both randomized controlled trials (RCTs) and comparative observational studies were included. Meta-analysis was performed separately for randomized and nonrandomized studies with subgroup analysis by study design and antibiotic. Results. Our review includes 44 articles (30 instrumented spinal fusions and 14 fracture repairs). Intrawound antibiotics significantly decreased the risk of developing SSIs in RCTs of fracture repair (RR 0.61, 95% CI: 0.40–0.93, I2 = 32.5%) but not RCTs of instrumented spinal fusion. Among observational studies, topical antibiotics significantly reduced the risk of SSIs in instrumented spinal fusions (OR 0.34, 95% CI: 0.27–0.43, I2 = 52.4%) and in fracture repair (OR 0.49, 95% CI: 0.37–0.65, I2 = 43.8%). Vancomycin powder decreased the risk of Gram-positive SSIs (OR 0.37, 95% CI: 0.27–0.51, I2 = 0.0%) and had no effect on Gram-negative SSIs (OR 0.95, 95% CI: 0.62–1.44, I2 = 0.0%). Conclusions. Prophylactic intrawound antibiotic administration decreases the risk of SSIs in fracture surgical fixation in randomized studies. Therapeutic efficacy in instrumented spinal fusion was seen in only nonrandomized studies. Vancomycin appears to be an effective agent against Gram-positive pathogens. There is no evidence that local vancomycin powder is associated with an increased risk for Gram-negative infection.

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Operative Rib Fracture Management

Schwed

Pieracci

2022

Management of Chest Trauma

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Salvage of rib stabilization hardware with antibiotic beads

Cited by 14 publications

References 19 publications

A Single-Center Experience of Osteosynthesis Material Infection after Rib Fixation for Blunt Trauma

A Single-Center Experience of Osteosynthesis Material Infection after Rib Fixation for Blunt Trauma

Prophylactic Topical Antibiotics in Fracture Repair and Spinal Fusion

Operative Rib Fracture Management

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