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• W4384948611 abstract "PURPOSE: Nasal fractures represent the most common fracture in facial trauma. The role of prophylactic antibiotics during treatment and recovery is debated, given low infection rates and demonstrated risks of antibiotic therapy. No current studies exist within the United States studying prophylactic antibiotic use for the treatment of nasal fractures. Furthermore, none study open fractures, nor do such investigations utilize standardized scoring systems to adjust for fracture severity. In order to remedy this vacuum in information, we assessed the impact of prophylactic antibiotic use on infection rate following traumatic nasal fracture within a large cohort of patients all managed by closed reduction. METHODS: A retrospective analysis was performed of a prospectively maintained plastic surgery facial trauma database at a Level I trauma center. Demographics, comorbidities, fracture classifications, and management of patients who received antibiotics at the time of closed nasal reduction were compared against those who did not receive antibiotics. Infection rates between groups were analyzed. Multivariate analysis was conducted to control for confounding variables. Qualitative analysis was performed for patients who experienced infection. RESULTS: 282 patients met inclusion criteria (n=144, antibiotic; n=138, non-antibiotic). Multiple demographic differences existed, which were each selected and adjusted for in our multivariate regression model. Six patients experienced infection (1 abscess, 5 sinus infections). There was no difference in infection rate between antibiotic and non-antibiotic groups (2.0% vs 2.2%, p=0.90). On binomial regression analysis controlling for potential confounders, the use of antibiotics did not significantly decrease odds of infection (OR 1.7, [0.17, 13.6], p=0.64). No other variables studied were associated with increased odds of infection, including the presence of packing (OR 0.18, [0.01-1.9], p=0.19), splinting (OR 1.3, [0.13-29.4], p=0.84), open fracture classification (OR 1.9, [0.08-20.8], p=0.64), or time to intervention (OR 1.5, [0.95-2.9], p=0.16). Similarly, increasing severity of injury based by Rohrich Classification did not significantly impact odds of infection (OR 0.68, [0.23-1.9], p=0.46). Qualitative analysis demonstrated all six patients who presented with infections were managed nonoperatively, indicating an overall infection rate of 2.5% at bedside versus 0% in the OR. CONCLUSION: Our study demonstrates that prophylactic antibiotics do not decrease infection rates following nasal fractures managed by closed reduction, including in open fracture cases. Given growing concerns of antibiotic over-prescription, and well-documented side effects of antibiotics, a risk-benefit analysis is warranted in the case of nasal fractures, where risk of infection is low. As such, when skin breaks are appropriately irrigated and managed per standard of care, we argue against the routine prescription of antibiotics in cases of isolated nasal fracture." @default.
• W4384948611 created "2023-07-22" @default.
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• W4384948611 date "2023-05-01" @default.
• W4384948611 modified "2023-10-16" @default.
• W4384948611 title "35. The Role of Antibiotics in Nasal Fractures following Closed Reduction" @default.
• W4384948611 doi "https://doi.org/10.1097/01.gox.0000937736.35020.03" @default.
• W4384948611 hasPublicationYear "2023" @default.
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