Salvage of rib stabilization hardware with antibiotic beads.

BACKGROUND: Surgical stabilization of rib fractures (SSRF) can be used to improve pulmonary mechanics; however, hardware infection is a morbid complication. Antibiotic impregnated beads have been used to suppress infection in orthopedic practices. We aimed to determine the efficacy of antibiotic beads for infected and at-risk SSRF hardware.

METHODS: This is a single institution retrospective review of adults (18 years or older) that received SSRF between 2009 and 2017. Infected and at-risk hardware were managed with antibiotic beads. The primary outcome was bony union of rib fractures.

RESULTS: There were 285 SSRF patients. Infection rate was 3.5%. Antibiotic beads were placed in 17 patients - 9 for infected hardware and 8 for prophylaxis. Increased body mass index (p = 0.04) and hemorrhagic shock at admission (p = 0.03) were risk factors for infection. There was 100% bony union post-operatively.

CONCLUSION: SSRF hardware infection is morbid. Antibiotic beads can salvage SSRF hardware until bony union.