Abstract
As shown by the studies of Gustilo–Anderson, infections are one of the most frequent complications in open fractures, owing to the heavy contamination of tissue during the trauma. Therefore, an immediate antibiotic prophylaxis capable of covering the majority of microbes involved in this type of contamination is needed. In this paper we address this need by proposing a diagnostic-therapeutic protocol.
Similar content being viewed by others
Bibliografia
Gustilo RB, Anderson JT (1976) Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Jt Surg, Am 58(4):453–458
Carver DC, Kuehn SB, Weinlein JC (2017) Role of systemic and local antibiotics in the treatment of open fractures. Orthop Clin N Am 48(2):137–153
Isaac SM, Woods A, Danial IN, Mourkus H (2016) Antibiotic prophylaxis in adults with open tibial fractures: what is the evidence for duration of administration? A systematic review. J Foot Ankle Surg 55(1):146–150
Dunkel N, Pittet D, Tovmirzaeva L et al. (2013) Short duration of antibiotic prophylaxis in open fractures does not enhance risk of subsequent infection. Bone Jt J 95-B(6):831–837
Giesecke MT, Schwabe P, Wichlas F et al. (2014) Impact of high prevalence of pseudomonas and polymicrobial gram-negative infections in major sub-/total traumatic amputations on empiric antimicrobial therapy: a retrospective study. World J Emerg Surg 9:55
Chen AF, Schreiber VM, Washington W et al. (2013) What is the rate of methicillin-resistant staphylococcus aureus and gram-negative infections in open fractures? Clin Orthop Relat Res 471(10):3135–3140
Andreoni F, Zürcher C, Tarnutzer A et al. (2017) Clindamycin affects group A Streptococcus virulence factors and improves clinical outcome. J Infect Dis 215(2):269–277
Schintler MV, Traunmüller F, Metzler J et al. (2009) High fosfomycin concentrations in bone and peripheral soft tissue in diabetic patients presenting with bacterial foot infection. J Antimicrob Chemother 64(3):574–578
Naique SB (2006) Management of severe open tibial fractures: the need for combined orthopaedic and plastic surgical treatment in specialist centres. J Bone Jt Surg, Br 88(3):351–357
Otchwemah R, Grams V, Tjardes T et al. (2015) Bacterial contamination of open fractures—pathogens, antibiotic resistances and therapeutic regimes in four hospitals of the trauma network Cologne, Germany. Injury 46(Suppl 4):104–108
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflitto di interesse
Gli autori E. Zamparini, E. Castiello, E. Marchionni, N. Rossi, G. Fornaro, C. Pungetti, D. Tigani e P. Viale dichiarano di non aver alcun conflitto di interesse.
Consenso informato e conformità agli Standard Etici
Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Essendo uno studio puramente descrittivo, non è stato necessario acquisire il consenso informato dei pazienti.
Human and Animal Rights
L’articolo non contiene alcuno studio eseguito su esseri umani e su animali da parte degli autori.
Rights and permissions
About this article
Cite this article
Zamparini, E., Castiello, E., Marchionni, E. et al. La profilassi antibiotica nelle fratture esposte: la proposta per un nuovo PDTA. LO SCALPELLO 33, 12–15 (2019). https://doi.org/10.1007/s11639-019-00306-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11639-019-00306-2