Salvage of rib stabilization hardware with antibiotic beads

Michelle S Junker; Alex Kurjatko; Matthew C Hernandez; Stephanie F Heller; Brian D Kim; Henry J Schiller

doi:10.1016/j.amjsurg.2019.02.032

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Salvage of rib stabilization hardware with antibiotic beads

Journal article

Peer reviewed

Salvage of rib stabilization hardware with antibiotic beads

Michelle S Junker, Alex Kurjatko, Matthew C Hernandez, Stephanie F Heller, Brian D Kim and Henry J Schiller

The American journal of surgery, Vol.218(5), pp.869-875

11/2019

DOI: 10.1016/j.amjsurg.2019.02.032

PMID: 30857639

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Abstract

Surgical stabilization of rib fractures (SSRF) can be used to improve pulmonary mechanics; however, hardware infection is a morbid complication. Antibiotic impregnated beads have been used to suppress infection in orthopedic practices. We aimed to determine the efficacy of antibiotic beads for infected and at-risk SSRF hardware. This is a single institution retrospective review of adults (18 years or older) that received SSRF between 2009 and 2017. Infected and at-risk hardware were managed with antibiotic beads. The primary outcome was bony union of rib fractures. There were 285 SSRF patients. Infection rate was 3.5%. Antibiotic beads were placed in 17 patients - 9 for infected hardware and 8 for prophylaxis. Increased body mass index (p = 0.04) and hemorrhagic shock at admission (p = 0.03) were risk factors for infection. There was 100% bony union post-operatively. SSRF hardware infection is morbid. Antibiotic beads can salvage SSRF hardware until bony union.

Adolescent

Adult

Aged

Aged, 80 and over

Anti-Bacterial Agents - administration & dosage

Anti-Bacterial Agents - therapeutic use

Female

Follow-Up Studies

Fracture Fixation, Internal - instrumentation

Humans

Internal Fixators - adverse effects

Internal Fixators - microbiology

Male

Middle Aged

Prosthesis-Related Infections - diagnosis

Prosthesis-Related Infections - drug therapy

Prosthesis-Related Infections - epidemiology

Prosthesis-Related Infections - prevention & control

Retrospective Studies

Rib Fractures - surgery

Salvage Therapy - methods

Surgical Wound Infection - diagnosis

Surgical Wound Infection - drug therapy

Surgical Wound Infection - epidemiology

Surgical Wound Infection - prevention & control

Treatment Outcome

Young Adult

Details

Title: Subtitle: Salvage of rib stabilization hardware with antibiotic beads
Creators: Michelle S Junker - Mayo Clinic
Alex Kurjatko - Mayo Clinic
Matthew C Hernandez - Mayo Clinic in Arizona
Stephanie F Heller - Mayo Clinic
Brian D Kim - Mayo Clinic
Henry J Schiller - Mayo Clinic
Resource Type: Journal article
Publication Details: The American journal of surgery, Vol.218(5), pp.869-875
DOI: 10.1016/j.amjsurg.2019.02.032
PMID: 30857639
ISSN: 0002-9610
eISSN: 1879-1883
Language: English
Date published: 11/2019
Academic Unit: Surgery
Record Identifier: 9984701641302771

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12 Times Cited - Web of Science