Surgical Site Infection Clinical Trial
Official title:
Does Prophylactic Local Tobramycin Injection Lower Open Fracture Infection Rates?
The goal of open extremity fracture (OEF) treatment is to promote fracture healing and restore function while preventing the development of infection. This is achieved through systematic and timely wound debridement and irrigation, fracture stabilization, tetanus prophylaxis, systemic and local antimicrobial therapy, and judicious timing of wound closure based on cleanliness. Early prophylactic systemic antibiotics lower infection rates in open fractures but have limitations of achieving adequate concentration at the hypoperfused wound area. OEF wounds are frequently poor in vasculature secondary to the soft tissue injury, hence adequate concentration of antibiotic cannot permeate to the tissue at risk. If systemic antibiotic concentrations are increased to achieve minimum inhibitory concentration (MIC) for pathogens at the wound, there is heightened concern for systemic drug toxicity. In sharp contrast, locally administered antibiotics achieve high drug concentration directly within the wound cavity with minimal systemic side effects. Local antibiotic therapy has shown to reduce rates of open fracture wound infection. With the serious implications of postoperative infections in OEF, it is imperative that all measures including further use of prophylactic local antibiotics be considered to prevent fracture-related infection (FRI). The overarching hypothesis for this project is that a novel synergistic combination of local aqueous tobramycin plus perioperative weight-based IV cephalosporin antibiotic prophylaxis will reduce the rate of FRI one year after OEF surgery. This in turn will improve OEF patient outcomes, decreasing morbidity and return to the operating room (OR) without any adverse effect on fracture healing. Regardless of the treatment group, bacterial speciation will be determined for patients that do develop FRI to help guide future treatment. The goal is to improve the clinical outcome and recovery of the population that sustains an OEF by decreasing the rate of FRI and fracture nonunions while concurrently educating on bacterial speciation and resistance.
n/a
Status | Clinical Trial | Phase | |
---|---|---|---|
Active, not recruiting |
NCT04096885 -
The Inselspital Surgical Cohort Study
|
||
Terminated |
NCT03820648 -
Wound Protector Dual-ring Alexis® in Pancreaticoduodenectomy
|
N/A | |
Completed |
NCT04067843 -
Effect of Photodynamic Treatment on Skin Microbiome. Single Center Study
|
N/A | |
Terminated |
NCT04042077 -
Delafloxacin IV and OS Administration Compared to Best Available Therapy in Patients With Surgical Site Infections
|
Phase 3 | |
Completed |
NCT05841576 -
Anaesthetic Management Guided by COMET Measurements
|
N/A | |
Withdrawn |
NCT05338281 -
NPWT for Abdominal Incisions in DIEP Reconstructions: A RCT
|
N/A | |
Recruiting |
NCT03042091 -
Neomycin and Metronidazole Hydrochloride With or Without Polyethylene Glycol in Reducing Infection in Patients Undergoing Elective Colorectal Surgery
|
Early Phase 1 | |
Completed |
NCT01697748 -
Prospective Study on Cesarean Wound Outcomes
|
N/A | |
Terminated |
NCT01789697 -
Text Message Study
|
N/A | |
Recruiting |
NCT05966961 -
Novosyn® CHD vs Polyglactin 910 Suture to Close Wounds After Emergency or Elective Laparotomy or Laparoscopic Surgery
|
||
Recruiting |
NCT05077592 -
Addition of Pre-wound Closure Povidone Iodine Wash Versus Direct Wound Closure Effect on Surgical Site Infections
|
Phase 4 | |
Recruiting |
NCT05763602 -
PVI to Prevent S. Aureus SSI After Fixation of HELEF (POTENT Study)
|
Phase 4 | |
Recruiting |
NCT05502380 -
Broad-spectrum Antibiotic Prophylaxis in Tumor and Infected Orthopedic Surgery
|
Phase 3 | |
Recruiting |
NCT03221023 -
Intrawound Vancomycin Prophylaxis for Neural Stimulator
|
Phase 2/Phase 3 | |
Completed |
NCT03257202 -
Topical Treatment and Prevalence of P. Acnes
|
Phase 2 | |
Completed |
NCT06154720 -
Surgical Site Infection After Episiotomy Repair Related to Routine Use of Antibiotic Prophylaxis in Low-Risk Population
|
||
Not yet recruiting |
NCT06465901 -
A Stratified, Multi-ARm, muLti-site Randomised Platform Trial Aiming to Reduce the INcidence of Post-operative SSI
|
N/A | |
Not yet recruiting |
NCT04820075 -
Efficacy of an Intervention to Improve the Preoperative Shower in Scheduled Surgery
|
N/A | |
Recruiting |
NCT03561376 -
Zinc Oxide Versus Petrolatum Following Skin Surgery
|
Early Phase 1 | |
Not yet recruiting |
NCT04496180 -
Prevena to Prevent Surgical Site Infection After Emergency Abdominal Laparotomy
|
N/A |