Concurrent Oral Surgery and Orthopaedic Treatment in the Multiply Injured Patient: Is There an Increased Incidence of Orthopaedic Sepsis?

Fifty-five patients requiring oral surgery and orthopaedic care were studied prospectively and compared to a control group. Six patients received no antibiotics and one developed an orthopaedic operative site infection due to a mouth organism. Seventeen patients had concurrent surgery and perioperative antibiotic usage and no infections occurred. Twenty-six patients required multiple operations and courses of antibiotic treatment and five developed infections. Enterobacter infections were common and emerge because they are resistant to first-generation cephalosporins. Treatment by a perioperative first-generation cephalospor in is recommended, followed by throat cultures and treatment by antibiotics specific for cultured organisms for patients requiring subsequent operations.