Antibiotic Prophylaxis for Open Fractures in the Emergency Department. (January 2015) - Weant, Kyle A.
Abstract : Emergency departments across the country regularly treat patients with traumatic injuries. One of the more common injuries that these patients present with is open fractures. Much of the morbidity associated with these fractures can be traced to the development of fracture-site infections that can lead to chronic osteomyelitis, impaired bone healing, and potential limb loss. Initial wound cultures in this setting are frequently positive, but they tend to demonstrate poor correlation with subsequent infections. The emergent management of open fractures includes a multipronged approach that includes stabilization, debridement, irrigation, soft tissue coverage, and systemic empiric antibiotics for prophylaxis. This review will discuss the etiology and factors associated with the development of infections in this setting, the use of empiric antibiotics, and the guidelines currently available.