Contemporary Concepts in Infection Prevention for Open Fractures: Focus on Antibiotic Prophylaxis and Surgical Protocols
Vol 06 Issue 1 | January 2025 | page: 02-06 | Hatia Marandi, Aurobinda Das
DOI: https://doi.org/10.13107/ojot.2025.v06.i01.62
Received 15/04/2024; Reviewed 23/05/2024; Accepted 08/10/2024; Published 10/01/2025
Authors: Hatia Marandi [1], Aurobinda Das [1]
[1] Department of Orthopaedics, Hitech Medical College and Hospital, Bhubaneswar, Odisha, India.
Address of Correspondence
Dr. Aurobinda Das,
Department of Orthopaedics, Hitech Medical College and Hospital, Bhubaneswar, Odisha, India.
Email: auro.d1984@gmail.com
Abstract
Introduction: Open fractures represent a critical orthopedic emergency characterized by significant soft-tissue disruption and a high propensity for infection, which can lead to devastating complications like chronic osteomyelitis and limb loss. Despite standardized care, infection rates remain high in severe injuries, necessitating a shift toward multimodal prevention strategies.
Objective: This review explores contemporary concepts in infection prevention for open fractures, specifically focusing on the evolution of systemic and local antibiotic delivery, innovations in implant technology, and evidence-based surgical protocols.
Methods: A synthesis of current clinical guidelines (WHO, CDC, and specialty societies) and recent research (up to 2025) was conducted to evaluate the efficacy of emerging prophylactic interventions and surgical site management techniques.
Results: Findings indicate that while prompt systemic antibiotic administration (within one hour of injury) remains the gold standard, adjunctive local delivery via antibiotic-impregnated beads or powders significantly reduces infection in high-grade fractures. Furthermore, innovations such as bioactive nanostructured implant coatings and pH-triggered antibacterial layers offer promising results in preventing biofilm formation. In surgical management, the selective use of prophylactic incisional negative pressure wound therapy (iNPWT) and standardized alcohol-based skin antisepsis have demonstrated efficacy in reducing surgical site infections (SSI).
Conclusion: Effective infection prevention in open fractures requires a transition from traditional monotherapy to a comprehensive, protocol-driven approach. Future directions emphasize the need for large-scale randomized trials to standardize local antibiotic dosing and the integration of “smart” biomaterials into routine clinical practice to further mitigate the burden of fracture-related infections.
Keywords: Open Fractures, Infection Prevention, Antibiotic Prophylaxis, Implant Coatings.
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| How to Cite this Article: Hatia Marandi H, Aurobinda Das A. Contemporary Concepts in Infection Prevention for Open Fractures: Focus on Antibiotic Prophylaxis and Surgical Protocol. The Odisha Journal of Orthopaedics and Trauma. January 2025; 06;01:02-06. https://doi.org/10.13107/ojot.2025.v06.i01.62 |
