In order to reduce open fractures and fixing internal fractures metal implants are preferred. Removal of implant after the fracture is fixed, is not so clear. It lacks proper guidelines. In case of any complication the implants are removed once the fracture is fixed whereas some doctors don’t suggests their removal1.
On the other note if the implants are present in ankle, they may cause pain during weight bearing activities. So in case of ankles, an ankle implant removal surgery is required2. The most common complication that occurs in case of surgery is (SI) surgical site infection3. Its rate can be decreased by using different antibiotics against infection4.
The infection cause during the surgical procedure could happen due to antibiotic, methicillin-resistant Staphylococcus epidermidis5 and also by other Staphylococcus species. These are vulnerable to cefuroxime or cefazolin type of cephalosporins antibiotics5. Usually, first generation or the second generation cephalosporins are used for prophylaxis6.
Furthermore, there is no adequate evidence for the possible advantageous effects of antibiotic prophylaxis on SI rates during removal of bone implants. Instead a high rate of SI is accounted for implant removal surgeries than internal fixation of fractures7. Therefore, antibiotic prophylaxis could be efficient before implant removal surgeries to diminish SI.
So researchers performed a study to evaluate the effect of cefazolin prophylaxis on the surgical site infection8.
It was a randomized study, 298 patients with implants removal surgeries had subjected into 2 groups. One was Control group and other one having cefazolin. The occurrence of deep and shallow surgical site infection, health related quality of life, functional outcome, visual analog scale, clinical and bacteriological assessments within 1 month after surgery were evaluated.
It was found that cefazolin group showed more accuracy. Both groups did not show a significant improvement in health-related quality of life, functional outcome and pain during 1 month. Single dose of 1 g of cefazolin prophylaxis reduced numbers of patients with the surgical site infection.
Written by: Rabeeia
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17 November, 2019