Michelle S Junker1, Alex Kurjatko2, Matthew C Hernandez3, Stephanie F Heller4, Brian D Kim5, Henry J Schiller6. 1. Division of Trauma, Critical Care, and General Surgery, Mayo Clinic Rochester, Rochester, MN, United States. Electronic address: junker.michelle@mayo.edu. 2. Division of Trauma, Critical Care, and General Surgery, Mayo Clinic Rochester, Rochester, MN, United States. Electronic address: kurjatko.alex@mayo.edu. 3. Division of Trauma, Critical Care, and General Surgery, Mayo Clinic Rochester, Rochester, MN, United States. Electronic address: hernandez.matthew@mayo.edu. 4. Division of Trauma, Critical Care, and General Surgery, Mayo Clinic Rochester, Rochester, MN, United States. Electronic address: heller.stephanie@mayo.edu. 5. Division of Trauma, Critical Care, and General Surgery, Mayo Clinic Rochester, Rochester, MN, United States. Electronic address: kim.brian@mayo.edu. 6. Division of Trauma, Critical Care, and General Surgery, Mayo Clinic Rochester, Rochester, MN, United States. Electronic address: schiller.henry@mayo.edu.
Abstract
BACKGROUND: Surgical stabilization of rib fractures (SSRF) can be used to improve pulmonary mechanics; however, hardware infection is a morbid complication. Antibiotic impregnated beads have been used to suppress infection in orthopedic practices. We aimed to determine the efficacy of antibiotic beads for infected and at-risk SSRF hardware. METHODS: This is a single institution retrospective review of adults (18 years or older) that received SSRF between 2009 and 2017. Infected and at-risk hardware were managed with antibiotic beads. The primary outcome was bony union of rib fractures. RESULTS: There were 285 SSRF patients. Infection rate was 3.5%. Antibiotic beads were placed in 17 patients - 9 for infected hardware and 8 for prophylaxis. Increased body mass index (p = 0.04) and hemorrhagic shock at admission (p = 0.03) were risk factors for infection. There was 100% bony union post-operatively. CONCLUSION: SSRF hardware infection is morbid. Antibiotic beads can salvage SSRF hardware until bony union.
BACKGROUND: Surgical stabilization of rib fractures (SSRF) can be used to improve pulmonary mechanics; however, hardware infection is a morbid complication. Antibiotic impregnated beads have been used to suppress infection in orthopedic practices. We aimed to determine the efficacy of antibiotic beads for infected and at-risk SSRF hardware. METHODS: This is a single institution retrospective review of adults (18 years or older) that received SSRF between 2009 and 2017. Infected and at-risk hardware were managed with antibiotic beads. The primary outcome was bony union of rib fractures. RESULTS: There were 285 SSRF patients. Infection rate was 3.5%. Antibiotic beads were placed in 17 patients - 9 for infected hardware and 8 for prophylaxis. Increased body mass index (p = 0.04) and hemorrhagic shock at admission (p = 0.03) were risk factors for infection. There was 100% bony union post-operatively. CONCLUSION: SSRF hardware infection is morbid. Antibiotic beads can salvage SSRF hardware until bony union.
Authors: Jeffrey J Aalberg; Benjamin P Johnson; Horacio M Hojman; Rishi Rattan; Sandra Arabian; Eric J Mahoney; Nikolay Bugaev Journal: J Trauma Acute Care Surg Date: 2021-08-01 Impact factor: 3.697
Authors: Eric K Kim; Claire A Donnelley; Madeline Tiee; Heather J Roberts; Ericka Von Kaeppler; David Shearer; Saam Morshed Journal: Adv Orthop Date: 2021-10-14