Adults aged 18-65 years with open tibial or femoral Gustilo-Anderson IIIA fractures who reached the hospital within 24 hours were eligible Open fracture Gustilo-Anderson IIIA antibiotic cement beads surgical site infection fracture-related infection tibia femur PMMA vancomycin gentamicin
Conditions
Interventions
In the index group, after meticulous debridement, povidone-iodine skin preparation, and low-pressure pulsed lavage with at least 3 L of normal saline, antibiotic cement beads were prepared by mixing 2
Experimental Other
Antibiotic-Loaded Cement Beads
Sponsors
Srinakharinwirot University
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Inclusion criteria
Inclusion criteria: Eligibility criteria for the index group were 1. Gustilo-Anderson type IIIA open fracture of the tibia or femur diagnosed by an attending orthopaedic surgeon 2. age 18 to 65 years (skeletally mature) 3. ability to attend follow-up for 6 months 4. hospital arrival within 24 hours of injury. Historical controls were identified from electronic medical records of patients who met identical inclusion criteria during the period preceding routine bead use, and who had complete demographic data, operative records, and follow-up radiographs at 1, 3, and 6 months.
Exclusion criteria
Exclusion criteria: Exclusion criteria for both groups were 1. known allergy to cephalosporins, aminoglycosides, penicillins, or PMMA constituents 2. previous surgery or infection at the same site 3.immunocompromise (uncontrolled diabetes mellitus, AIDS, end-stage renal disease) 4. cognitive impairment that precluded follow-up 5. subsequent amputation 6. development of multidrug-resistant infection prior to bead implantation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Infection rate 6 months after the intervention Incidence of infection (present of any sign based on CDC National Healthcare Safety Network (NHSN) surgical-site-infection criteria and the Govaert fracture-related-infection (FRI) consensus) | — |
Secondary
| Measure | Time frame |
|---|---|
| Union score 1,3, and 6 months after the intervention Modified Radiographic Union Score for Tibial Fractures | — |
Countries
Thailand
Contacts
Public ContactWittawat Boonyanuwat
Faculty of Medicine, Srinakharinwirot University
Outcome results
None listed