Status:

COMPLETED

Local Antibiotic Therapy to Reduce Infection After Operative Treatment of Fractures at High Risk of Infection: A Multicenter Randomized, Controlled Trial (VANCO)

Lead Sponsor:

Major Extremity Trauma Research Consortium

Conditions:

Post Operative Surgical Site Infection

Eligibility:

All Genders

18-80 years

Phase:

PHASE3

Brief Summary

The Vancomycin Study is a multi-center, prospective randomized controlled trial that will compare the proportion of deep surgical site infections within 6 months in patients treated with local Vancomy...

Detailed Description

Primary Aim: Compare the proportion of deep surgical site infections within 6 months in patients treated with local Vancomycin powder compared to those treated without local Vancomycin powder. Primar...

Eligibility Criteria

Inclusion

  • All "high energy" tibial plateau fractures treated operatively with plate and screw fixation.
  • We define "high energy" tibial plateau fractures as patients who are either:
  • Initially treated with an external fixation (with or without limited internal fixation) and treated definitively more than 3 days later after swelling has resolved.
  • Any open type I, II, or IIIA fracture, regardless of timing of definitive treatment.
  • Any tibial plateau fracture associated with ipsilateral leg compartment syndrome fasciotomy wounds.
  • All "high energy" pilon (distal tibial plafond) fractures treated operatively with plate and screw fixation. We define "high energy" pilon fractures as patients who are either:
  • Initially treated with an external fixation (with or without fibula fixation or limited internal fixation) and treated definitively more than 3 days later after swelling has resolved.
  • Any open type I, II, or IIIA fracture, regardless of timing of definitive treatment.
  • Any tibial pilon fracture associated with ipsilateral leg compartment syndrome fasciotomy wounds.
  • Ages 18 to 80 years
  • Patients may have co-existing non-tibial infection, with or without antibiotic treatment.
  • Patients may have risk factors for infection including diabetes, immunosuppression from steroids or other medications, HIV, or other infections.
  • Patients may have a head injury
  • Patients may have a portion of the fixation (e.g. fibula fixation in pilon or percutaneous screws across a tibial plateau fracture) prior to definitive plate fixation, at the initial surgery before randomization.
  • Patients may have other orthopedic and non-orthopaedic injuries.
  • Patients may have pre-existing musculoskeletal injuries, be non ambulators, or have spinal cord injuries.
  • Women and minorities are included

Exclusion

  • The study injury: tibial plateau, pilon, is already infected at time of study enrollment.
  • Patient speaks neither English nor Spanish.
  • Patients who have already had definitive fixation prior to enrollment in the study.
  • Severe problems with maintaining follow-up (e.g. patients who are homeless at the time of injury or those how are intellectually challenged without adequate family support).
  • Patients with allergies, drug administration reactions, or other sensitivities to Vancomycin (such as a history of Redman's Syndrome).
  • Pregnancy.
  • The study injury is a type IIIB or IIIC open fracture.

Key Trial Info

Start Date :

October 1 2014

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

November 1 2019

Estimated Enrollment :

1036 Patients enrolled

Trial Details

Trial ID

NCT02227446

Start Date

October 1 2014

End Date

November 1 2019

Last Update

June 1 2021

Active Locations (1)

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University of Maryland R Adams Cowley Shock Trauma Center

Baltimore, Maryland, United States, 21201