What is the ideal composition of antibiotic impregnated (ABI) spacers/ beads in post-traumatic infections? Is preoperative microbial identification necessary?

Author: Leonard Marais

RECOMMENDATION: There is currently limited evidence with regards to the ideal composition of ABI polymethyl methacrylate (PMMA) spacers or beads in post-traumatic infections and the need for preoperative identification of the causative organism. Available data suggests that PMMA spacers, empirically impregnated with at least 2 gm of vancomycin per 40 mg of PMMA (with or without gentamycin), may result in quiescence of infection in a high percentage of cases with an acceptable associated rate of bony union. Preoperative microbial identification is of unclear utility.

LEVEL OF EVIDENCE: Limited

DELEGATE VOTE: Agree: 95%, Disagree: 0%, Abstain: 5% (Unanimous, Strongest Consensus)

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