3 takeaways on the risk of SSI during below-the-knee fracture repair implant removal

Antibiotic prophylaxis with a single preoperative dose of intravenous cefazolin does not reduce the risk of surgical site infection after the removal of orthopedic implants used to treat fractures below the knee, a study in JAMA found.

Here are three things to know:

1. Following clean (class I, not contaminated) surgical procedures, the SSI rate should be less than about 2 percent. However, an infection rate of 12.2 percent has been reported after removing orthopedic implants used for treatment of fractures below the knee.

2. This randomized clinical trial included 470 patients undergoing surgery for removal of implants for below-the-knee fractures. A single preoperative intravenous dose of 1000 milligrams of cefazolin or sodium chloride were administered to 228 or 242 patients, respectively.

3. A single preoperative dose of intravenous cefazolin compared with saline did not reduce the risk of SSI within 30 days following implant removal.

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