The microbiological basis for a revised antibiotic regimen in high-energy tibial fractures: Preventing deep infections by nosocomial organisms

Following high-energy open fracture, a single prophylactic antibiotic regimen directed against environmental wound contaminants does not provide cover for the organisms responsible for deepest SSI's and may have depopulated the niche, promoting nosocomial contamination prior to definitive closure. We advocate a dynamic prophylactic strategy, tailoring a second wave of prophylaxis against nosocomial organisms at the time of definitive wound closure, and at the same time avoiding the potential complications of prolonged antibiotic use. Glass GE, Barrett SP, Sanderson F, Pearse MF, Nanchahal J. J Plast Reconstr Aesthet Surg. 2011 Mar;64(3):375-80. Epub 2010 Jun 29. PMID: 20591757 PDF

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