Antibiotic Prophylaxis in Bacterial Infection of Type IIIA Open Fracture of Tibial ShaftWith orWithout Fibula Fracture


1 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, IR Iran

2 Orthopedic Research Center,Mashhad University of Medical Sciences,Mashhad, IR Iran

3 Department of Research and Education, Razavi Hospital, Mashhad, IR Iran

4 Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran

5 Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran



Abstract Background: Amajor purpose of treating open fractures is the prevention of wound infection. Infection, as amajor complication associated with open fractures,may lead to limb loss, sepsis, and even death. In this study, we survey factors affecting infection. Objectives: In this study, we survey factors affecting infection. Patients and Methods: The study population consisted of all patients with type IIIA gastilo open fractures of tibial shaft, with or without fibula fracture (caused by trauma). Afterwound irrigation, debridement, andwound swab sampling formicrobial culture, all patients received prophylactic antibiotic regimens in fitting with their wound class. No topical antibiotics were used with a 6-month follow-up for any symptomof osteomyelitis. Results: Considering the occurrence of one case of infection, the infection ratewas calculated (1.89%). Given the lowprevalence rate of infection, itwas difficult to evaluate the effect of different antibiotic regimens on the prevention of infection (in terms of regimen duration). As such, no specific regimen was preferred. The results of statistical analysis did not show any significant difference between one-day application of antibiotic prophylaxis and two or three days consumption of antibiotic prophylaxis. Conclusions: According to the results of this study, one-day administration of antibiotics as prophylaxis (first generation of cephalosporins) was sufficient for the prevention of infection after orthopedic surgery in all patients except in patient with risk factors such as diabetes or immune deficiency, when the administration of prophylactic antibiotic lasts for 3 days.