Evidence map›Paper›PMID 29417348›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2018

Perioperative management of external fixation in staged protocols: an international survey.

Sandro Hodel, Björn-Christian Link, Reto Babst, W H Mallee, Philippe Posso, Frank J P Beeres, Collaborators (18)

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Strategies to minimize soft tissues and septic complications in staged management of high-energy proximal tibia fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2020
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sandro HodelDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland.
Björn-Christian LinkDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, Spitalstrasse 16, Luzern 16, Switzerland.
Reto BabstDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland.
W H MalleeDepartment of Orthopaedic Surgery, Academic Medical Center of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Philippe PossoDepartment of Orthopaedic Surgery, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland.
Frank J P BeeresDepartment of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland. frank.beeres@luks.ch.
Collaborators (18)

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite the frequent use of external fixation, various regimes of antibiotic prophylaxis, surgical technique and postoperative pin care exist and underline the lack of current evidence. The aim of the study was to assess the variability or consensus in perioperative protocols to prevent implant-associated infections for temporary external fixation in closed fractures of the extremities. MATERIALS AND

methodsA 26-question survey was sent to 170 members of the Traumaplatform. The survey included questions concerning demographics, level of training, type of training and perioperative protocols as: antibiotic prophylaxis, intraoperative management, disinfection and postoperative pin site care. All responses were statistically analysed, and intraoperative measures rated on a 5-point Likert scale.

resultsThe responses of fifty orthopaedic trauma and general surgeons (response rate, 29.4%) were analysed. The level of experience was more than 5 years in 92% (n = 46) with up to 50 closed fractures of the extremities annually treated with external fixation in 80% (n = 40). Highest consensus could be identified in the following perioperative measures: preoperative antibiotic prophylaxis with a second-generation cephalosporin (86%, n = 43), changing gloves if manipulation of the external fixator is necessary during surgery (86%, n = 43; 4.12 points on the Likert scale), avoid overlapping of the pin sites with the definitive implant site (94%, n = 47; 4.12 points on the Likert scale) and soft tissue protection with a drill sleeve (83.6%, n = 41).

conclusionOur survey could identify some general principles, which were rated as important by a majority of the respondents. Futures studies' focus should elucidate the role of perioperative antibiotics and different disinfection protocols on implant-associated infections after temporary external fixation in staged protocols. LEVEL OF EVIDENCE: This study provides Level IV evidence according to Oxford centre for evidence-based medicine.

Indexed as

External FixatorsAntibiotic ProphylaxisBone NailsClinical CompetenceClinical Decision-MakingConsensusDisinfectionFracture FixationGlobal HealthGloves, SurgicalHumansIntraoperative CareOrthopedic SurgeonsPostoperative CarePractice Patterns, Physicians'Prosthesis-Related InfectionsExternal fixationFracturePerioperative managementTrauma

Identifiers

PMID29417348

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.