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Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
Open Fracture Antibiotics prophylaxis
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Open Fracture Antibiotics prophylaxis

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Antibiotics prophylaxis for different types of bone fractures pre-op

Antibiotics prophylaxis for different types of bone fractures pre-op

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  • 1. Dr. Richard Chmielewski Dr. Abdul Hamid Alraiyes
  • 2.  80 years old CF  Chief Complain  Fall  Pain on the Lt elbow  Transferred from another ER with a diagnosis of:  Fracture of the Lt proximal ulna  Open fracture type I.  ID consult : POD # 1  For ABx prophylaxis because of the open fracture type I.
  • 3.  PMHx:  Hypertension  Hyperlipidemia  PSHx:  Lt THR (3 years)  Lt Fibula # with plate and I.M nailing. (8 years )  NKDA  No blood transfusion  Meds:  Tenormine 50 mg PO QD  Social Hx:  No Hx Of smoking / ETOH/ elicit drugs
  • 4.  Physical Exam:  V/S : 36.8 - 120/76 - 67 – 17  HEENT: Broses on the chin  Chest: CTA bil.  CVS: S1 + S2 + PSM III/VI  ABD: soft, Lax and no tenderness  EXT: no edema , good pulse , Lt upper arm dressed with a cast.  Labs:  WBC = 10.4 , Hb= 12.4, Ht= 37, Plt= 241  Na= 140, K= 4, Cl= 104, CO2= 28, BUN= 15, Cr= 0.5, Glu= 110
  • 5.  Dose the patient need Abx prophylaxis?  If yes, what Abx should be used & for how long?  What else should be considered apart from Abx prophylaxis?
  • 6. The Abx prophylaxis depends on the type of the open fracture
  • 7. • Wound less than 1 cm, • without contamination • minimal injury of soft tissue.
  • 8. • Wound between 1 -10 cm • mild contamination • extensive soft tissue damage and moderate crushing component.
  • 9. • Wound larger than 10 cm • severe contamination • severe crushing component.
  • 10. antibiotics “Gram Positive coverage” should be started as soon as possible after injury and continued for 3 days* *J Am Acad Orthop Surg. 2006 Oct;14(10 Suppl):S98-S100
  • 11. antibiotics “Gram Positive coverage” should be started as soon as possible after injury and continued for 3 days* *J Am Acad Orthop Surg. 2006 Oct;14(10 Suppl):S98-S100
  • 12. antibiotics “Gram Positive coverage” should be started as soon as possible after injury and continued for 5 days* combined with local therapy consisting of antibiotic-impregnated polymethylmethacrylate beads *J Am Acad Orthop Surg. 2006 Oct;14(10 Suppl):S98-S100
  • 13. Tetanus vaccination history .

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