Intrawound Tobramycin Plus Vancomycin to Prevent Surgical Site Infection in Tibial Fractures

Is the combination of intrawound tobramycin and vancomycin powder more effective than vancomycin powder alone to reduce deep surgical site infection in periarticular tibial fracture?In this randomized clinical trial of 1528 adults who had undergone surgery for a periarticular tibial fracture, deep surgical site infections occurred in 51 participants (182-day probability, 7.4%) in the treatment group and 47 participants (182-day probability, 6.6%) in the control group.Among participants with periarticular tibial fractures, the combination of intrawound tobramycin and vancomycin powder was not superior to vancomycin powder alone in reducing deep surgical site infection.

Corresponding Author: Robert V. O’Toole, MD, Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 S Greene St, T3M15, Baltimore, MD 21201 (rotoole@som.umaryland.edu).

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