Highlights
- •SSRF hardware infection increases hospital and ICU duration of stay.
- •Antibiotic beads suppress SSRF hardware infection to allow bony union.
- •Hemorrhagic shock on admission and increased BMI are infection risk factors.
Abstract
Background
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.
Methods
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.
Results
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.
Conclusion
SSRF hardware infection is morbid. Antibiotic beads can salvage SSRF hardware until
bony union.
Keywords
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Article info
Publication history
Published online: March 01, 2019
Accepted:
February 26,
2019
Received in revised form:
February 21,
2019
Received:
August 14,
2018
Footnotes
☆Presentation: This was presented as a podium presentation at Western Trauma Association 48th Annual Meeting in Whistler, British Columbia on February 27, 2018.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
