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Antibiotics for pelvic fracture

docrickfry at aol.com docrickfry at aol.com
Thu Apr 13 17:11:35 BST 2006


DB--
You are quoting some old sources as that text has been out of print for quite a few years if I am not mistaken, and simply because someone says this is so does not constitute evidence of benefit.  I agree that antibiotics have not been shown to be of benefit in this setting at preventing the development of pelvic sepsis, tho I would be happy to see any data that does exist indicating otherwise--and again, by data, I do not mean someone simply saying so.   The most important thing that prevents sepsis in this setting is vigorous mechanical cleansing and dressing of the wounds regularly, evacuating hematomas whenever possible, avoidance of contamination (i.e. especially by fecal diversion)and early skeletal fixation.  Antibiotics are just not the magic potions/panacea that so many healthcare providers would believe, in fact you are endangering not helping the patient if you give them when there is no indication as if they are some sort of magic.
Witch doctor medicine still lives!
ERF
 
-----Original Message-----
From: bensonblues at comcast.net
To: trauma-list at trauma.org
Sent: Thu, 13 Apr 2006 14:24:51 +0000
Subject: Antibiotics for pelvic fracture


Tim, The reference for A/Bs in pelvic fractures is Management of Trauma: 
Pittfalls and Practice, Walt and Wilson, 2nd Ed., pp596-7. " Efforts to prevent 
pelvic sepsis are important...it is not clear how long such antibiotics should 
be given, 4-6 days should be adequate." They also reference Siebel, et. al,: 
Pelvic Fracture, in Clinical Care and Pathophysiology, 1987; Peltier: 
Complications associated with fractures of the pelvis, J Bone Joint Surg 1965, 
and Trunkey, et al: Management of pelvic fractures in blunt trauma injury, J 
Trauma 1974. But, if you say they are not indicated, that's okay. Right or 
wrong, I'm a lowly ER doc who, if initially treating a blunt trauma victim with 
an acetabular fracture, would be be inclined to give antibiotics in the ED in 
anticiption of intraabdominal injuries. DB
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