Objectives: To analyze the efficacy of subgroups of various intrawound local antibiotics in reducing the rate of fracture-related infections.
Data Sources And Study Selection: PubMed, MEDLINE via Ovid, Web of Science, Cochrane database, and Science Direct were searched for articles in English on July 5, 2022, and December 15, 2022.
Study Selection: All clinical studies comparing the incidence of fracture-related infection between the administration of prophylactic systemic and topical antibiotics in fracture repair were analyzed.
Data Extraction: Cochrane collaboration's assessment tool and the methodological bias and the methodological index for nonrandomized studies were used to detect bias and evaluate the quality of included studies, respectively.
Data Synthesis: RevMan 5.3 software (Nordic Cochrane Centre, Denmark) was used to conduct the meta-analyses and generate forest plots.
Conclusions: From 1990 to 2021, 13 studies included 5309 patients. Nonstratified meta-analysis showed that intrawound administration of antibiotics significantly decreased the overall incidence of infection in both open and closed fractures, regardless of the severity of open fracture and antibiotics class [OR = 0.58, ( P = 0.007)] [OR = 0.33, ( P < 0.00001)], respectively. The stratified analysis revealed that prophylactic intrawound antibiotics significantly lowered infection rate in open fracture patients with Gustilo-Anderson type I (OR = 0.13, P = 0.004), type II (OR = 0.29, P = 0.0002), type III (OR = 0.21, P < 0.00001), when either tobramycin PMMA beads (OR = 0.29, P < 0.00001) or vancomycin powder (OR = 0.51, P = 0.03) was applied. This study demonstrates prophylactic administration of intrawound antibiotics significantly decreases the overall incidence of infection in all subgroups of surgically fixated fractures but does not affect the patient's length of hospital stay.
Level Of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BOT.0000000000002641 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intrawound vancomycin powder in primary total knee arthroplasty: Does it reduce early postoperative infection?
Knee
December 2024
Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, Bloomington, MN, USA; Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis Park, MN, USA; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA. Electronic address:
Background: The purpose of this retrospective analysis of a prospective quality control project was to determine whether the use of intrawound vancomycin powder (IVP) decreases the rate prosthetic joint infection (PJI) within 90-days following primary total knee arthroplasty (TKA).
Methods: From October 2021-September 2022, a prospective quality control project was undertaken in which 10 high-volume arthroplasty surgeons alternated between using IVP and not using IVP each month. Patients who received IVP were compared to those who did not.
Does the Application of Topical Vancomycin Reduce Surgical Site Infections in Spine Surgery? A Meta-analysis of Randomized Controlled Trials.
Clin Orthop Relat Res
December 2024
Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Background: Surgical site infections (SSIs) represent a major challenge in spine surgery, leading to severe morbidity, mortality, and increased costs. The local application of antibiotics, particularly vancomycin, has emerged as a potential strategy. Individual randomized controlled trials (RCTs) have disagreed about the efficacy of topical vancomycin in preventing SSIs after spine surgery, and so a meta-analysis that pools data from those RCTs might be helpful to inform clinicians' decisions on the topic.
View Article and Find Full Text PDF[Utility of topical vancomycin application in the prevention of surgical site infection of the lumbosacral spine].
Acta Ortop Mex
May 2024
Centro Médico ABC. Ciudad de México.
Introduction: surgical site infections (SSI) remain a significant cause of morbidity and mortality and one of the most representative causes of nosocomial infections. The use of intrawound vancomycin in lumbar spine surgery is a potential prophylactic measure against SSI; however, evidence regarding its efficacy is contradictory. Our study was designed to research if intrawound vancomycin significantly prevents SSI in lumbar spine surgery.
View Article and Find Full Text PDFEfficacy of Intrawound Vancomycin in Prevention of Periprosthetic Joint Infection After Primary Total Knee Arthroplasty: A Prospective Double-Blinded Randomized Control Trial.
J Arthroplasty
June 2024
Sunshine Bone and Joint Insitute, KIMS-Sunshine Hospitals, Hyderabad, India.
Background: Periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is a devastating complication. Intrawound vancomycin powder has been shown to reduce infection rates in spine surgery, but its role in arthroplasty remains controversial. This prospective randomized control trial aimed to evaluate the efficacy of intrawound vancomycin in preventing PJI after primary TKA.
View Article and Find Full Text PDFIntrawound Vancomycin Powder in Primary Total Hip Arthroplasty: A Prospective Quality Control Study.
J Arthroplasty
September 2024
Department of Orthopaedic Surgery, TRIA Orthopaedic Institute, Bloomington, Minnesota; Department of Orthopaedic Surgery, Park Nicollet Methodist Hospital, St. Louis Park, Minnesota; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota.
Background: The purpose of this retrospective analysis of a prospective quality control project was to determine whether the use of intrawound vancomycin powder (IVP) decreases the rate of periprosthetic joint infection (PJI) within 90 days following primary total hip arthroplasty (THA).
Methods: From October 2021 to September 2022, a prospective quality control project was undertaken in which 10 high-volume THA surgeons alternated between using and not using IVP each month while keeping other perioperative protocols unchanged. A retrospective analysis of the project was performed to compare the group of patients who received IVP to the group of patients who did not.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!