BACKGROUND: The purpose of this study was to determine the efficacy of local wound cavity injections of aqueous @entity581 ( @entity801 and @entity2890 ), in conjunction with systemic antibiotics, to lower the prevalence of @entity281 in @entity1 with @entity4422 . METHODS: Three hundred and fifty-one @entity4422 were identified by Current Procedural Terminology codes 11011 and 11012. Data on @entity1 demographic characteristics, injury characteristics, @entity281 , and @entity174 union were obtained from the electronic medical records. @entity1 in the control group (183 @entity174 ) received systemic antibiotics only. @entity1 in the intervention group (168 @entity174 ) received, in addition to systemic antibiotics, a locally administered @entity5292 (2 mg/mL) at the time of the index surgical procedure. At the discretion of the attending surgeon, some wounds also received postoperative irrigations of aqueous @entity5292 (n = 34). For wounds that could not be closed and wounds that received postoperative irrigations, negative pressure dressings were used. RESULTS: The deep and superficial @entity281 rate in the control group was 19.7% (thirty-six of 183 @entity174 ), but it was significantly lower (p = 0.010) in the intervention group at 9.5% (sixteen of 168 @entity174 ). When comparing only the @entity281 , the @entity281 rate in the control group was 14.2% (twenty-six of 183 @entity174 ) compared with 6.0% (ten of 168 @entity174 ) in the intervention group (p = 0.011). After multivariate analysis to adjust for possible confounding factors, the administration of local antibiotics was found to be an independent predictor of lower @entity281 rates in both deep and superficial infections (odds ratio, 2.6 [95% confidence interval, 1.2 to 5.6]; p = 0.015) and @entity281 only (odds ratio, 3.0 [95% confidence interval, 1.1 to 8.5]; p = 0.034). The use of local antibiotics did not have an impact on nonunion rate (p = 0.881), with a type-I error rate of a = 0.05 and 0.8 power. CONCLUSIONS: This study suggests that local aqueous @entity5292 administration as an adjunct to systemic antibiotics may be effective in lowering @entity281 rates in @entity4422 ; further research with higher-level research designs are needed. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Local Injection of Aminoglycosides for Prophylaxis Against XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity801 :: ('MESH:D005839', 'Chemical') :: ['gentamicin'] @entity2890 :: ('MESH:D014031', 'Chemical') :: ['tobramycin'] @entity4422 :: ('MESH:D005597', 'Disease') :: ['open fractures'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'fracture'] @entity5292 :: ('D000617', 'Chemical') :: ['aminoglycoside'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection', 'deep infections'] @entity581 :: ('MESH:D000617', 'Chemical') :: ['aminoglycosides']
@entity4422 :: (MESH:D005597,Disease) :: ['Infection in Open Fractures']
