Earlier debridement and antibiotic administration decrease infection.
Timing of debridement and local antibiotic administration on infection has not been clearly defined. A contaminated critical size rat femur defect model was used to determine if earlier debridement with local antibiotics decreased infection. Defects were inoculated with Staphylococcus aureus. At 2, 6, or 24 hours following contamination, defects were irrigated and debrided then directly closed or treated with antibiotic-impregnated PMMA beads and then closed. Two weeks later, defects were examined for evidence of infection. There was a significant increase in evidence of infection between 2 and 6 hours and a further increase between 6 and 24 hours with debridement alone as well as with debridement plus local antibiotics. Treatment with antibiotics resulted in significantly less evidence of infection at 2 and 6 hours compared to debridement alone. It was concluded that early debridement in combination with local delivery of antibiotics of contaminated defects may reduce infections.
Brown
Kate V
KV
US Army Institute of Surgical Research, 3400 Rawley E Chambers, Suite B, Fort Sam Houston, TX 78234, USA. katevbrown@aol.com
Walker
John A
JA
Cortez
Douglas S
DS
Murray
Clinton K
CK
Wenke
Joseph C
JC
D000818:Animals; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D003646:Debridement; D005264:Femoral Fractures / Q000150:complications* / Q000382:microbiology; D005597:Fractures, Open / Q000150:complications* / Q000382:microbiology; D051381:Rats; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000517:prevention & control; D013997:Time Factors; D014946:Wound Infection / Q000209:etiology / Q000517:prevention & control*
D000891:Anti-Infective Agents, Local