scholarly journals Comparison of Infection Rates according to the Period of Prophylactic Antibiotic Use after Surgery in Patients with Distal Radius Fractures

2021 ◽  
Author(s):  
Joonha Lee ◽  
Yohan Lee ◽  
Yong Gil Jo ◽  
Sang Yoon Kang ◽  
Kee Jeong Bae
Keyword(s):  
Surgical Site Infection ◽  
Distal Radius ◽  
Open Reduction ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Distal Radius Fractures ◽  
Site Infection ◽  
Radius Fractures

Purpose: In general orthopedic surgery, the use of prophylactic antibiotics to prevent infection is recommended to be administered within 24 hours. However, there was no analysis on the incidence of surgical site infection according to the duration of use of prophylactic antibiotics for upper extremity fractures. This study aims to derive the appropriate prophylactic antibiotic using time by analyzing the incidence of infection according to the time of prophylactic antibiotic use in distal radius fractures.Methods: We retrospectively analyzed patients who used prophylactic antibiotics among patients who underwent open reduction and internal fixation for distal radius fractures from April 2018 to May 2021. The time of use of prophylactic antibiotics was classified into the 1-day group used, from 1 hour before surgery to 24 hours after the first administration, and the long-term group, continuously administered until discharge after surgery. Demographic characteristics, infection rate, C-reactive protein, risk factors for surgical site infection, and bone union were compared between the two groups.Results: A total of 168 patients were included in the study, 73 in the 1-day group and 95 in the long-term group. Superficial infection occurred in seven patients in the 1-day group and nine in the long-term group, and there was no statistically significant difference in the incidence rates of the two groups (p=0.980). Conclusion: The use of prophylactic antibiotics for 24 hours does not show a significant increase in the infection rate compared to the case of continuous use during open reduction and internal fixation of distal radius fractures.

scholarly journals Survey of Surgeons Regarding Prophylactic Antibiotic Use in Inguinal Hernia Repair

2018 ◽  
Vol 107 (3) ◽  
pp. 208-211 ◽  
Author(s):  
A. P. MacCormick ◽  
J. A. Akoh
Keyword(s):  
Surgical Site Infection ◽  
Perceived Risk ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Hernia Surgery ◽  
Trust Network ◽  
Surgical Trainees ◽  
Infected Mesh

Purpose: The use of prophylactic antibiotics in the mesh repair of inguinal hernias remains controversial. The aim of this study was to determine the perception of surgeons about surgical site infection and how this affects their clinical practice. Methods: A SurveyMonkey of general surgeons and senior surgical trainees was conducted via the local trust network and the questionnaire was displayed on the website of the Association of Surgeons of Great Britain and Ireland and Association of Surgeons in Training. Results: Eighty-one responses were received from surgeons who perform an average of 75 hernia repairs per year – the majority by open technique. Thirty-six (44.4%) used routine antibiotic prophylaxis, 40 (49.4%) selectively, and five (6.2%) not at all as the five surgeons who did not use antibiotics perceived their surgical site infection rate to be <1% and have never removed an infected mesh from a hernia wound. There was no clear difference between those who use prophylactic antibiotics routinely or selectively as the experience of mesh explantation is similar (56% versus 55% had 2–10 meshes removed respectively). Seventy-seven (95%) of surgeons felt a new specific set of guidelines was required. Conclusion: This study highlights the fact that in the absence of clear guidelines, most surgeons base their use of prophylactic antibiotics on their perceived risk or experience of surgical site infection. There is a strong need for a new set of guidelines to address the use of prophylactic antibiotics in groin hernia surgery.

Treatment of Distal Radius Fractures in Women Older than 80 Years: A Preliminary Report of Functional and Radiographic Outcomes after Open Reduction and Internal Fixation

2021 ◽  
Author(s):  
Lili E. Schindelar ◽  
Richard M. McEntee ◽  
Robert E. Gallivan ◽  
Brian Katt ◽  
Pedro K. Beredjiklian
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Open Reduction ◽  
The Elderly ◽  
Distal Radius Fractures ◽  
Implant Design ◽  
Complication Rates ◽  
Radius Fractures ◽  
Hardware Failures

Abstract Background Distal radius fractures are one of the most common fractures seen in the elderly. The management of distal radius fractures in the elderly, especially patients older than 80 years, has not been well defined. The purpose of this study was to evaluate operative treatment of distal radius fractures in patients older than 80 years to determine functional outcomes and complication rates. Materials and Methods A retrospective review was performed to identify patients 80 years or older who were treated for a distal radius fracture with open reduction and internal fixation (ORIF). Medical records were reviewed for demographics, medical history, functional outcomes including quick Disabilities of the Arm, Shoulder, and Hand (qDASH), radiographs, and postoperative complications. Results There were 40 patients included for review. Average age was 84 years. The preoperative qDASH score was 69. At 6 months follow-up, the postoperative qDASH score was 13 (p < 0.001). There were five (12.5%) complications reported postoperatively. All fractures healed with adequate radiographic alignment and there were no hardware failures. Conclusion Distal radius fractures in patients older than 80 years treated with ORIF have good functional outcomes and low complication rates. Increased functionality and independence of the elderly, as well as updated implant design can lead to the effective surgical management of these patients. When indicated from a clinical perspective, operative fixation of distal radius fractures should be considered in patients older than 80 years.

scholarly journals The Use of Oral Antibiotics to Prevent Surgical Site Infection on Postoperative Modified Radical Mastectomy Patients in Dr. Soetomo General Hospital, Surabaya

2021 ◽  
Vol 56 (1) ◽  
pp. 36
Author(s):  
Norman Hadi ◽  
Hantoro Ishardyanto
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
General Hospital ◽  
Radical Mastectomy ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Modified Radical Mastectomy ◽  
Significant Difference

Surgical operations on modified radical mastectomy are considered clean procedures by the Centers for Disease Control and Prevention (CDC) wound classification system. Despite this, higher than expected Surgical Site Infection (SSI) rates are reported, varying from 1 % to 26 % across the literature. Some surgeons also prescribe postoperative prophylaxis for postoperative modified radical mastectomy patients to prevent infection despite its lack of proven efficacy. The aim of this study is to analyze the use of oral antibiotics to prevent Surgical Site Infection (SSI) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. This study was double-blinded randomized control trial of 60 postoperative modified radical mastectomy patients (2 groups) during the period of December 2017 to March 2018. Samples were prospectively divided into two groups (random sampling), in group A (n=30) patients received single dose prophylactic antibiotics and continued with oral antibiotics postoperative (Cefadroxil 2 x 500 mg) during 7 days and in group B (n=30) patients received single dose prophylactic antibiotics and continued without postoperative antibiotics (placebo). Both groups were evaluated clinically for surgical site infection up to 30 days. There was no statistically significant difference in both groups {p=1 (p>0.05)}. There was no incidence of surgical site infection in both groups during the 30-day follow-up period (days 3, 7, 14 and 30). There was no difference in the surgical site infection rate among those who received oral postoperative antibiotics prophylactic and without antibiotics (placebo) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.

Analysis of Our Open Reduction and Internal Fixation of Distal Radius Fractures in Adults: Are We Over Operating?

2021 ◽  
Author(s):  
George W.V. Cross ◽  
Ramandeep S. Saini ◽  
Mohammed Monem ◽  
Rajesh Sofat
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Plain Radiograph ◽  
Distal Radius Fractures ◽  
British Society ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Radiological Parameters ◽  
New Guidelines

Abstract Background Fractures of the distal radius are a common injury. The British Orthopaedic Association (BOA) and The British Society for Surgery of the Hand (BSSH) have released new guidelines outlining the management of these fractures, specifically identifying “thresholds for intervention,” based on radiological parameters for management with open reduction and internal fixation (ORIF). Questions/Purposes Have our distal radius fractures (DRFs), previously managed with ORIF, met the new guidelines' thresholds for intervention, based on radiological parameters? Patients and Methods A retrospective assessment of DRFs treated with ORIF was performed between January 2017 and August 2018. Patients were categorized into three cohorts based on their age. The five radiological parameters of ulnar variance, dorsal tilt, radial inclination, radial height, and intra-articular step were measured on the initial plain radiograph, “pre-manipulation film,” postplaster application radiograph, and “post-manipulation film.”These were compared with the “thresholds for intervention” outlined in the BOA/BSSH guidelines. Results A total of 94 patients underwent an ORIF with a mean age of 56 years (range 17–86 years). As many as 75.74% of patients on the ”pre-manipulation film” met the “threshold for intervention” on at least one radiological parameter, while 53.57% of patients on the “post-manipulation” met at least one “threshold for intervention.” Dorsal tilt was the parameter that most often met the threshold in both films at 53.37% and 40.11%, respectively. Conclusion Within our trust, there is a tendency to over manage the distal radius fracture with ORIF, potentially resulting in unnecessary operations. Education surrounding the new guidelines will better serve our decision-making. Level of Evidence This is a level III study.

scholarly journals Use of Cobra External Fixator for treatment of Distal Radius Fractures

2018 ◽  
Vol 9 (6) ◽  
pp. 84-89
Author(s):  
Niraj Ranjeet ◽  
Pratyenta Raj Onta ◽  
Krishna Sapkota ◽  
Pabin Thapa ◽  
Krishna Wahegoankar ◽  
...  
Keyword(s):  
Distal Radius ◽  
External Fixator ◽  
Treatment Options ◽  
Distal Radius Fractures ◽  
Medical Sciences ◽  
Radius Fractures ◽  
Ao Classification ◽  
Functional Activities ◽  
Clavicle Fractures

Background: Distal radius fractures are one of the commonest injuries only after clavicle fractures. These fractures poses challenges to the treating surgeons as a result of which these fractures are sometime treated unacceptably and leads to poor outcome. Among various treatment options for these fractures wrist sparing Cobra external fixator is one of the options with an impressive stability and outstanding functional outcomes.Aims and Objectives: To determine whether this system can achieve adequate reduction of a variety of DRF, is able to maintain reduction despite hand and wrist movements, whether it compromises hand and wrist functions and leads to long term problems.Materials and Methods: From July 1, 2016 - June 30, 2017, all skeletally matured patients with acute distal radius fractures (AO-A2, B1, C1, C2) were adequately reduced and fixed with Cobra ex-fix. Immediately post-op patients were encouraged to start range of motion of the wrist as the pain decreased. The patients were followed up in 2,4 and 8 weeks and were analyzed clinically, radiologically, their functional outcomes and any complications.Results: Twenty-two patients were included in our study. Nine were males and 13 were females. Using the AO classification, 15 were classified as A2, 2 were B1, 3 were C1, and 2 were C2. The mean number of weeks the cobra fixator was maintained was 5.3 weeks. The Cobra ex-fix was able to achieve excellent maintenance of radial height and radial inclination and good maintenance of dorsal tilt. Recovery of functional activities according to Gartland and Werley’s functional scoring system was good to excellent in all patients at 8 weeks follow-up.Conclusion: The Cobra external fixation system is an outstanding device for use in fractures of the distal radius. It achieves superior anatomic correction and is dependable in maintaining fracture reduction even with hand and wrist use.Asian Journal of Medical Sciences Vol.9(6) 2018 84-89

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