In 2007 we published an animal study (Yarboro S, Baum E, Dahners L: Locally Administered Antibiotics for Prophylaxis Against Surgical Wound Infection. Journal Bone Joint Surgery 2007 89(5)) documenting that injecting gentamicin into contaminated wounds after closure of the incision results in several orders of magnitude reduction in bacteria counts as opposed to systemic cephalosporins such as are usually given to prophylax against infection. This results in high concentrations in the wound cavity which are not achieved by IV administration and by injecting it after wound closure it is not removed before closure like antibiotic irrigation solutions. It worked significantly better than sustained release pellets at reducing bacterial counts. I have incorporated this into my trauma practice by injecting (80mg gentamicin in 40cc saline, inject enough to fill the wound) a gentamicin solution after the wound is closed and been very pleased with the reduction in the numbers of infections, especially in open fractures. Data that we published in the August 2009 JBJS suggest that systemic cephalosporins and local gentamicin have a large synergistic effect, so I would recommend doing both.

Dr. Dahners is a Professor of Orthopaedic Surgery at the UNC School of Medicine in Chapel Hill, NC, USA.  His clinical focus is on trauma and his research interests are in ligament physiology, ligament healing, ligament growth and contracture, and bone healing and the biomechanics of internal fixation.  You can see his “Pearls” of orthopaedics on OrthopaedicList.com.

Dr. Dahners et al published “Better Prophylaxis Against Surgical Site Infection with Local as Well as System Antibiotics.  An in Vivo Study” in the August 2009 issue of the Journal of Bone and Joint Surgery.

When someone develops an infection at a hospital or other patient care facility that they did not have prior to treatment, this is referred to as a healthcare-associated (sometimes hospital-acquired) infection (HAI).  According to the World Health Organization (WHO), at any point in time, 1.4 million people worldwide suffer from infections acquired in hospitals.

As part of an ongoing commitment to quality care and infection prevention, nationwide doctors and hospitals are partnering with Kimberly-Clark to deliver continuing education programs on healthcare-associated infection (HAI) prevention to staff and management Whether you’re a healthcare professional, patient, or visitor , the most effective way to keep HAIs down to a minimum is to wash your hands or use an alcohol-based sanitizer.

Please view the informational video at this link.

For more information please go to the Not on My Watch campaign.

Barbara Dunn was born in Jersey City, New Jersey, worked as an interior designer in Manhattan, then moved to Hawaii where she worked for a production company before moving to Arlington and reinventing herself as a PR executive.