Atwan Yousif, Miclau Theodore, Schemitsch Emil H, Teague David
Division of Orthopaedic Surgery, Western University, London.
Department of Orthopaedic Surgery, University of California, San Francisco, Orthopaedic Trauma Institute, Zuckerberg San Francisco General Hospital, San Francisco, CA.
OTA Int. 2020 Mar 23;3(1):e071. doi: 10.1097/OI9.0000000000000071. eCollection 2020 Mar.
Open fractures are complex presentations with elevated risks of infection and nonunion due to a multitude of factors. Along with early surgical debridement, antibiotics have been heavily utilized and have become part of standard of care to reduce the risks of fracture-related infections. Many aspects of their use have been studied and debated. The early administration of intravenous antibiotics has been shown to significantly reduce the incidence of infection. Furthermore, current standards do not recommend prolonged antibiotic administration post wound closure. Recently, an increasing number of studies have assessed the utility of locally administered antibiotics. Clinical and basic science studies have been relatively supportive of their usage, but further studies are still warranted to further delineate their effects.
开放性骨折是一种复杂的病症,由于多种因素,其感染和骨不连的风险较高。除了早期手术清创外,抗生素已被大量使用,并已成为降低骨折相关感染风险的标准治疗的一部分。抗生素使用的许多方面都已得到研究和讨论。静脉注射抗生素的早期使用已被证明可显著降低感染发生率。此外,目前的标准不建议在伤口闭合后长期使用抗生素。最近,越来越多的研究评估了局部使用抗生素的效用。临床和基础科学研究相对支持其使用,但仍需要进一步研究以进一步明确其效果。