Intrawound Antibiotic Powder Decreases Frequency of Deep Infection and Severity of Heterotopic Ossification in Combat Lower Extremity Amputations

Clinical Orthopaedics and Related Research
Gabriel J PaveyBenjamin K Potter

Abstract

Amputations sustained owing to combat-related blast injuries are at high risk for deep infection and development of heterotopic ossification, which can necessitate reoperation and place immense strain on the patient. Surgeons at our institution began use of intrawound antibiotic powder at the time of closure in an effort to decrease the rate of these surgical complications after initial and revision amputations, supported by compelling clinical evidence and animal models of blast injuries. Antibiotic powder may be useful in reducing the risk of these infections, but human studies on this topic thus far have been inconclusive. We sought to determine whether administration of intrawound antibiotic powder at the time of closure would (1) decrease the risk of subsequent deep infections of major lower-extremity combat-related amputations, and (2) limit formation and decrease severity of heterotopic ossification common in the combat-related traumatic residual limb. Between 2009 and 2015, 252 major lower extremity initial and revision amputations were performed by a single surgeon. Revision cases were excluded if performed specifically to address deep infection, leaving 223 amputations (88.5%) for this retrospective analysis. We revie...Continue Reading

References

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Apr 9, 2017·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Jonathan G SeaveyThomas A Davis

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Citations

May 20, 2020·Journal of Orthopaedic Trauma·Benjamin W HoytBenjamin K Potter
Apr 23, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Stephen D FernicolaScott C Wagner
Apr 18, 2021·Injury·Steven A HortonRobert V O'Toole

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