Role of Systemic and Local Antibiotics in the Treatment of Open Fractures

Orthop Clin North Am. 2017 Apr;48(2):137-153. doi: 10.1016/j.ocl.2016.12.005. Epub 2017 Jan 30.

Abstract

The orthopedic community has learned much about the treatment of open fractures from the tremendous work of Ramon Gustilo, Michael Patzakis, and others; however, open fractures continue to be very difficult challenges. Type III open fractures continue to be associated with high infection rates. Some combination of systemic and local antibiotics may be most appropriate in these high-grade open fractures. Further research is still necessary in determining optimal systemic antibiotic regimens as well as the role of local antibiotics. Any new discoveries related to novel systemic antibiotics or local antibiotic carriers will need to be evaluated related to cost.

Keywords: Calcium sulfate; Chitosan sponge; Infection; Local antibiotics; Open fractures; PMMA; Systemic antibiotics.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Antibiotic Prophylaxis / methods*
  • Drug Administration Routes
  • Fractures, Bone / complications*
  • Fractures, Open / complications*
  • Humans
  • Treatment Outcome
  • Wound Infection* / etiology
  • Wound Infection* / prevention & control

Substances

  • Anti-Bacterial Agents