Antibiotic prophylaxis type, length of surgery among factors impacting acute infection rate

Issue: April 2014

NEW ORLEANS — A paper presented here by researchers from Torino, Italy found a link between several preoperative factors and acute infection following treating surgical treatment of proximal humeral fractures.

Davide Blonna, MD, and colleagues performed a logistic regression analysis for 452 patients with proximal humeral fractures that underwent surgical fixation. Patients in one group had first-generation cephalosporin with standard skin preparation, and patients in another group had third-generation cephalosporin and other antibiotics for double preparation. Researchers analyzed patient demographics, length of surgery, comorbidities, type of fixation and surgical delay.

Overall, 18 patients (4%) developed infection. Patients who had third-generation cephalosporin had a significantly lower rate of infection than patients who had the first-generation antibiotic. Average delay to surgery was approximately 6 days and a longer delay significantly correlation with infection, Blonna noted during his presentation at the American Academy of Orthopaedics Surgeons Annual Meeting. Age, sex, comorbidity and types of reduction and fixation had no statistically significant effect on the rate of acute infection.

A summary of the major univariate analysis determined “the type of antibiotic prophylaxis, the length of surgery and the skin preparation with chlorhexidine seems to have an effect on acute infection,” Blonna said. – by Christian Ingram

Reference:

Blonna D. Paper #736. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.

Disclosure: Blonna is a paid speaker for Orthofix Inc.