ORLANDO — Use of vancomycin powder compared with the standard of care reduced the rate of gram-positive surgical site infections in patients with tibial plateau or pilon fractures, according to a presenter at the Orthopaedic Trauma Association Annual Meeting.

Robert V. O’Toole , MD, and colleagues performed a phase 3, prospective, randomized clinical trial of 984 patients from 36 Level-1 trauma centers with tibial plateau or pilon fractures treated with either plate or screw fixation. There were 481 patients assigned to treatment with 1,000 mg of vancomycin powder placed before wound closure and 499 patients were assigned to a control group that received the standard of care. At 2 weeks, 12 weeks and 26 weeks after fixation, follow-ups were performed. Deep surgical site infection (SSI) within 6 months based on CDC criteria was the primary outcome.