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La profilassi delle infezioni nelle fratture esposte

Prophylaxis of infections in open fractures

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LO SCALPELLO-OTODI Educational

Abstract

The correct prophylaxis of infections in open fractures needs a first stage consisting in early and aggressive orthopaedic treatment, an appropriate broad-spectrum antibiotic treatment and, if possible, a second stage of specific antibiotic treatment. Published data support the conclusion that a course of antibiotic therapy, begun as soon as possible after injury, significantly lowers the risk of infection when used in combination with prompt, modern orthopaedic fracture wound management.

Various antibacterial agents have been successfully evaluated in prophylaxis. Drugs should be active against the most common pathogens involved in bone infection.

In bone surgery a first or second cephalosporin, such as cefazolin, is a rational choice in type I and II open fractures. In type III open-fracture patients with high-grade fractures, who represent patients at high risk, the use of antibiotic coverage extending to Gram-positive and Gram-negative multi-resistant bacilli must be considered for the choice of antibiotic prophylaxis. Large, randomised, blinded trials are needed to prove the effects of extended antibiotic coverage on nosocomial infections.

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Authors and Affiliations

  1. UOC di Ortopedia e Traumatologia, Ospedale San Paolo, ASL Napoli 1 Centro, Napoli, Italia

    Giuseppe Monteleone

  2. Dipartimento di Malattie Infettive, Ospedale D. Cotugno, AORN Dei Colli, Napoli, Italia

    Tiziana Ascione

Authors
  1. Giuseppe Monteleone
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  2. Tiziana Ascione
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Correspondence to Giuseppe Monteleone.

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Gli autori Giuseppe Monteleone e Tiziana Ascione dichiarano di non avere alcun conflitto di interesse.

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Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.

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Monteleone, G., Ascione, T. La profilassi delle infezioni nelle fratture esposte. LO SCALPELLO 30, 11–15 (2016). https://doi.org/10.1007/s11639-016-0152-1

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  • DOI: https://doi.org/10.1007/s11639-016-0152-1

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