Use of Intrawound Antibiotics in Orthopaedic Surgery.

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Abstract

[Indexed for MEDLINE] 19. Injury. 2019 Jun;50 Suppl 1:S45-S49. doi: 10.1016/j.injury.2019.03.044. Epub 2019 Apr 1. Pin tract infection prophylaxis and treatment. Guerado E(1), Cano JR(2), Fernandez-Sanchez F(3). Author information: (1)Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Marbella (Malaga), Spain. Electronic address: eguerado@hcs.es. (2)Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Marbella (Malaga), Spain. (3)Microbiology Unit, Hospital Universitario Costa del Sol, University of Malaga, Marbella (Malaga), Spain. Pin tract infection in external fixation (ExFix) is a frequent finding which can eventually lead to loosening, osteomyelitis and loss of fixation. Its diagnosis is based on high empiricism and low validity, although it is possible to distinguish between minor and major infection. The first is limited to soft tissues, whereas the latter includes bone involvement. The rate of infection after conversion of external fixation to intramedullary nailing (IMN) is not well known. Unfortunately, papers referring to infection after the conversion of ExFix to intramedullary nailing (IMN) are of evidence level IV or V. It is suggested that conversion of ExFix to IMN should be carried out in a 2 step regimen. The time interval of 2 step regimen is uncertain although some authors have recommended to occur within 9 days. There is no consensus as to which prophylaxis protocol should be applied prior to conversion. In order to throw more light into this important issue, registries capturing important related parameters to the development of infection should be established. Copyright © 2019. Published by Elsevier Ltd. DOI: 10.1016/j.injury.2019.03.044