Risk of surgical site infection after lower limb implant removal not reduced with cefazolin
A single preoperative dose of IV cefazolin did not reduce the risk of surgical site infection within 30 days following removal of orthopedic implants used for treatment of fractures below the knee compared with saline, according to results published in JAMA.
Tim Schepers , MD, PhD, and colleagues randomly assigned 500 patients with previous surgical treatment for fractures below the knee and who were undergoing removal of orthopedic implants to receive either a single preoperative IV dose of cefazolin or sodium chloride. The primary outcome measure was surgical site infection (SSI) within 30 days as measured by the criteria from the CDC, while secondary outcome measures included functional outcome, health-related quality of life and patient satisfaction.
Overall, 470 patients completed the study. Of these, 228 were in the cefazolin group and 242 were in the saline group. Results showed 14% of patients overall developed an SSI. In the cefazolin group, 13.2% of patients developed an SSI vs. 14.9% in the saline group. Researchers noted no significant differences in any of the secondary outcome measures postoperatively between groups.
“In this multicenter randomized clinical trial (including 470 patients) patients undergoing surgery for removal of orthopedic implants, used for treatment of fractures below the knee (eg, foot, ankle and lower leg), a single dose of intravenous cefazolin prophylaxis compared with saline did not appear to reduce the risk of surgical site infection within 30 days following implant removal,” Schepers told Healio.com/Orthopedics. “The rates of postoperative wound complications were high (13.2% vs. 14.9%), and future research should focus on the cause of these high rates and on strategies to lower these numbers.” – by Casey Tingle
Disclosure: Funding was received from ZonMW, the Netherlands organization for health research and development grant.