ReviewAdvances in orthopedics2021
Prophylactic Topical Antibiotics in Fracture Repair and Spinal Fusion.
Review in Advances in orthopedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Conflict wounds and antimicrobial resistance: a systematic review on local antimicrobials to prevent infection after extremity open fracture.BMJ military health · 2026Pooled it
- A meta-analysis of the efficacy of topical antibiotics in spinal surgery for the prevention of surgical site infection.Medicine · 2025Pooled it
- Vancomycin presoak reduces infection in anterior cruciate ligament reconstruction: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2023Pooled it
- Comparison of postoperative infection risk with and without topical vancomycin in adult posterior spinal fusion: a propensity-matched cohort study of 126,910 patients.Spine deformity · 2026Article
- Antimicrobial-laden PerOssal beads display in vitro inhibition and killing of extensively drug-resistant Gram-negative bacteria associated with conflict wounds in Ukraine.Bone & joint research · 2026Article
- Modulation of Surgical Site Infection Risk in Spinal and Thoracic Surgeries Through Operative Parameters: A Narrative Review.Journal of clinical medicine · 2025Review
- Antibiotic Use in Adult Spine Deformity Surgery: Results From the AO Spine Surveillance of the Management of Patients With Adult Spine Deformity.Global spine journal · 2025Article
- The use of antibiotic impregnated fenestrated screws in instrumentation for osteomyelitis: A case report.Surgical neurology international · 2025Article
- Adjuvant local antibiotic therapy in the management of diabetic foot osteomyelitis.Clinical diabetes and endocrinology · 2024Article
- A pilot, masked, randomized controlled trial to evaluate local gentamicin versus saline in open tibial fractures (pGO-Tibia).OTA international : the open access journal of orthopaedic trauma · 2023Article
- Evidence for Local Antibiotics in the Prevention of Infection in Orthopaedic Trauma.Journal of clinical medicine · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe objective of this systematic review with meta-analysis is to determine whether prophylactic local antibiotics prevent surgical site infections (SSIs) in instrumented spinal fusions and traumatic fracture repair. A secondary objective is to investigate the effect of vancomycin, a common local antibiotic of choice, on the microbiology of SSIs.
methodsAn electronic search of PubMed, EMBASE, and Web of Science databases and major orthopedic surgery conferences was conducted to identify studies that (1) were instrumented spinal fusions or fracture repair and (2) had a treatment group that received prophylactic local antibiotics. Both randomized controlled trials (RCTs) and comparative observational studies were included. Meta-analysis was performed separately for randomized and nonrandomized studies with subgroup analysis by study design and antibiotic.
resultsOur review includes 44 articles (30 instrumented spinal fusions and 14 fracture repairs). Intrawound antibiotics significantly decreased the risk of developing SSIs in RCTs of fracture repair (RR 0.61, 95% CI: 0.40-0.93,
conclusionsProphylactic intrawound antibiotic administration decreases the risk of SSIs in fracture surgical fixation in randomized studies. Therapeutic efficacy in instrumented spinal fusion was seen in only nonrandomized studies. Vancomycin appears to be an effective agent against Gram-positive pathogens. There is no evidence that local vancomycin powder is associated with an increased risk for Gram-negative infection.
Identifiers
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Registered trials
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.