{"id":245,"date":"2016-09-05T07:22:14","date_gmt":"2016-09-05T11:22:14","guid":{"rendered":"http:\/\/www.orthopaediclist.com\/blog\/?p=245"},"modified":"2016-09-05T07:22:14","modified_gmt":"2016-09-05T11:22:14","slug":"local-antibiotics-in-prophylaxis-of-surgical-wound-infections","status":"publish","type":"post","link":"https:\/\/www.orthopaediclist.com\/blog\/local-antibiotics-in-prophylaxis-of-surgical-wound-infections\/","title":{"rendered":"Local Antibiotics in Prophylaxis of Surgical Wound Infections"},"content":{"rendered":"<h3>by Laurence E. Dahners, MD<\/h3>\n<p><small>August 22nd, 2009<\/small><\/p>\n<div>\n<p>In 2007 we published an animal study (<em>Yarboro<\/em><em>\u00a0S, Baum E,\u00a0Dahners\u00a0L: Locally Administered Antibiotics for Prophylaxis Against Surgical Wound Infection.\u00a0<a title=\"jbjs\" href=\"http:\/\/www.orthopaediclist.com\/cme-organizations-details.asp?ProductID=6536\" target=\"_self\">Journal Bone Joint Surgery\u00a0<\/a><\/em>2007 89(5)) documenting that injecting gentamicin into contaminated wounds\u00a0<strong>after closure of the incision\u00a0<\/strong>results in several orders of magnitude reduction in bacteria counts as opposed to systemic cephalosporins such\u00a0as are usually given to prophylax against infection. This results in high concentrations in the wound cavity which are not achieved by IV administration and by injecting it after wound closure it is not removed before closure like antibiotic irrigation solutions. It worked significantly better than sustained release pellets at reducing bacterial counts. I have incorporated this into my trauma practice by injecting (80mg gentamicin in 40cc saline, inject enough to fill the wound) a gentamicin solution after the wound is closed and been very pleased with the reduction in the numbers of infections, especially in open fractures.\u00a0Data that we published in the August 2009 JBJS suggest that systemic cephalosporins and local gentamicin have a large synergistic effect, so I would recommend doing both.<\/p>\n<p><em>Dr. Dahners is a Professor of Orthopaedic Surgery at the UNC School of Medicine in Chapel Hill, NC, USA.\u00a0\u00a0His clinical focus is on trauma and his research interests are in ligament physiology, ligament healing, ligament growth and contracture, and bone healing and the biomechanics of internal fixation.\u00a0\u00a0You can see his \u201c<a title=\"Pearls\" href=\"http:\/\/www.orthopaediclist.com\/cme-organizations-details.asp?ProductID=6534\" target=\"_self\">Pearls<\/a>\u201d of orthopaedics on\u00a0<a title=\"OrthopaedicList.com\" href=\"http:\/\/www.orthopaediclist.com\/\" target=\"_self\">OrthopaedicList.com<\/a>.<\/em><\/p>\n<p><em>Dr. Dahners et al published \u201cBetter Prophylaxis Against Surgical Site Infection with Local as Well as System Antibiotics.\u00a0 An in Vivo Study\u201d in the August 2009 issue of the\u00a0<a title=\"jbjs\" href=\"http:\/\/www.orthopaediclist.com\/cme-organizations-details.asp?ProductID=6536\" target=\"_self\">Journal of Bone and Joint Surgery<\/a>.<\/em><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>by Laurence E. Dahners, MD August 22nd, 2009 In 2007 we published an animal study (Yarboro\u00a0S, Baum E,\u00a0Dahners\u00a0L: Locally Administered Antibiotics for Prophylaxis Against Surgical Wound Infection.\u00a0Journal Bone Joint Surgery\u00a02007 89(5)) documenting that injecting gentamicin into contaminated wounds\u00a0after closure of the incision\u00a0results in several orders of magnitude reduction in bacteria counts as opposed to systemic [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21,25],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Local Antibiotics in Prophylaxis of Surgical Wound Infections - OrthopaedicLIST.com Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.orthopaediclist.com\/blog\/local-antibiotics-in-prophylaxis-of-surgical-wound-infections\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Local Antibiotics in Prophylaxis of Surgical Wound Infections - OrthopaedicLIST.com Blog\" \/>\n<meta property=\"og:description\" content=\"by Laurence E. Dahners, MD August 22nd, 2009 In 2007 we published an animal study (Yarboro\u00a0S, Baum E,\u00a0Dahners\u00a0L: Locally Administered Antibiotics for Prophylaxis Against Surgical Wound Infection.\u00a0Journal Bone Joint Surgery\u00a02007 89(5)) documenting that injecting gentamicin into contaminated wounds\u00a0after closure of the incision\u00a0results in several orders of magnitude reduction in bacteria counts as opposed to systemic [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.orthopaediclist.com\/blog\/local-antibiotics-in-prophylaxis-of-surgical-wound-infections\/\" \/>\n<meta property=\"og:site_name\" content=\"OrthopaedicLIST.com Blog\" \/>\n<meta property=\"article:published_time\" content=\"2016-09-05T11:22:14+00:00\" \/>\n<meta name=\"author\" content=\"James Hundley, MD\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"James Hundley, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.orthopaediclist.com\/blog\/local-antibiotics-in-prophylaxis-of-surgical-wound-infections\/\",\"url\":\"https:\/\/www.orthopaediclist.com\/blog\/local-antibiotics-in-prophylaxis-of-surgical-wound-infections\/\",\"name\":\"Local Antibiotics in Prophylaxis of Surgical Wound Infections - OrthopaedicLIST.com Blog\",\"isPartOf\":{\"@id\":\"https:\/\/www.orthopaediclist.com\/blog\/#website\"},\"datePublished\":\"2016-09-05T11:22:14+00:00\",\"dateModified\":\"2016-09-05T11:22:14+00:00\",\"author\":{\"@id\":\"https:\/\/www.orthopaediclist.com\/blog\/#\/schema\/person\/87a719b32f490b91a2f4a6a44d4d6752\"},\"breadcrumb\":{\"@id\":\"https:\/\/www.orthopaediclist.com\/blog\/local-antibiotics-in-prophylaxis-of-surgical-wound-infections\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.orthopaediclist.com\/blog\/local-antibiotics-in-prophylaxis-of-surgical-wound-infections\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.orthopaediclist.com\/blog\/local-antibiotics-in-prophylaxis-of-surgical-wound-infections\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.orthopaediclist.com\/blog\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Local Antibiotics in Prophylaxis of Surgical Wound Infections\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.orthopaediclist.com\/blog\/#website\",\"url\":\"https:\/\/www.orthopaediclist.com\/blog\/\",\"name\":\"OrthopaedicLIST.com Blog\",\"description\":\"News About Orthopaedic Surgery and Orthopaedic Products and Services\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.orthopaediclist.com\/blog\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/www.orthopaediclist.com\/blog\/#\/schema\/person\/87a719b32f490b91a2f4a6a44d4d6752\",\"name\":\"James Hundley, MD\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.orthopaediclist.com\/blog\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/210425b5d38259409c4acb9bbb1e31bf?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/210425b5d38259409c4acb9bbb1e31bf?s=96&d=mm&r=g\",\"caption\":\"James Hundley, MD\"},\"description\":\"Dr. Hundley is a retired orthopaedic surgeon and the originator and co-founder of OrthopaedicLIST.com, a resource website for orthopaedic surgeons and related professionals.\",\"sameAs\":[\"http:\/\/www.orthopaediclist.com\"],\"url\":\"https:\/\/www.orthopaediclist.com\/blog\/author\/hundleysr\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Local Antibiotics in Prophylaxis of Surgical Wound Infections - OrthopaedicLIST.com Blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.orthopaediclist.com\/blog\/local-antibiotics-in-prophylaxis-of-surgical-wound-infections\/","og_locale":"en_US","og_type":"article","og_title":"Local Antibiotics in Prophylaxis of Surgical Wound Infections - OrthopaedicLIST.com Blog","og_description":"by Laurence E. 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