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- Talk
- Canada
How Successful is Antibiotic Treatment for Superficial SSIs following Open Fracture? A Fluid Lavage of Open Wounds (FLOW) Cohort Secondary Analysis
Description
In this presentation, Carlos Prada discusses a secondary analysis of the FLOW trial, which was a multicenter international study evaluating the impact of various irrigation pressures and surgical techniques on the occurrence of surgical site infections (SSIs) and the need for reoperations following open fracture treatments. The analysis aims to fill knowledge gaps regarding the behavior of superficial SSIs that persist despite antibiotic treatment and to identify associated risk factors.
Two primary questions drive the analysis: first, what percentage of patients with superficial SSIs developed persistent infections despite receiving antibiotics, and second, what factors are linked to infections that do not resolve with antibiotic therapy. Additionally, the microbiological profiles of participants with cultured infections were assessed.
Out of 2,445 patients in the FLOW trial, nearly 7% experienced a superficial SSI; however, only 139 of these were managed nonoperatively with antibiotics alone. Encouragingly, 97 patients saw their infections resolve, indicating a success rate of 7%. The analysis also noted that the timing of the diagnosis of surgical site infections significantly affected the chance of resolution. With a model built on eight identified risk factors—including age and Gustilo grade—results indicated that longer intervals from the surgery to SSI diagnosis correlate with reduced chances of antibiotic effectiveness.
Furthermore, the microbiological analysis revealed that staphylococcal species were the most commonly identified pathogens among those whose infections did not resolve, while a higher percentage of cultures were obtained in the unsuccessful treatment group, highlighting the complexity of these infections.
The findings suggest that while antibiotic treatment for superficial SSIs is viable, the timing of diagnosis is critical for successful management. The study points to the need for extended follow-up to discern the long-term status of these infections. Although limitations in the participant data restrict subgroup analyses, the presentation concludes that further research is necessary to refine treatment options and improve patient outcomes in the face of these infections.