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Early antibiotic administration did not decrease infection in patients with open-tibia fractures
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VANCOUVER, British Columbia — Early administration of antibiotics in patients with open-tibia fractures did not decrease the risk of infection, according to a presenter at the Orthopaedic Trauma Association Annual Meeting.
“Our study results further reinforce the importance of early transfer to [a] definitive trauma center for patients with open-tibia fractures as indicated by increased infection in patients arriving 6 hours after injury,” Steven F. Shannon, MD, said during his presentation
Shannon and colleagues performed a retrospective prognostic study at an urban Level 1 Trauma Center of 289 patients with Gustilo-Anderson type I –III open -tibia fractures with a minimum 3-month follow-up. Investigators noted the primary outcome measure was deep surgical site infection treated with surgical debridement. The time variables of interest included: antibiotic timing, time to debridement and time to arrival. Shannon noted the threshold of 66 minutes was identified for antibiotic timing and 6 hours for time of arrival to definitive trauma center.
Patients with infections were compared with those without infections with regard to injury severity, comorbidities, age, Injury Severity Score, tobacco use, diabetes BMI and cefazolin used as primary antibiotic.
There were 58 patients who developed a deep infection. Time to antibiotic administration within 66 minutes correlated with increased infection rate. Type IIIB/ C fractures were seen more often in patients who arrived at the trauma center within 66 minutes. There was no statistically significant correlation between antibiotic timing and infection, according to a subgroup analysis which excluded type IIIB/ C fractures.
Results from multivariate analysis showed predictors for an increased risk of deep surgical site infection included type IIIB/C fractures and patients with a delayed arrival to the definitive trauma center of more than 6 hours. – by Monica Jaramillo
Reference:
Shannon SF, et al. Paper #111. Presented at: Orthopaedic Trauma Association Annual Meeting. Oct. 11-14, 2017; Vancouver, British Columbia.
Disclosure: Shannon reports no relevant financial disclosures.