In Periarticular Tibial Fracture Repair, Should Tobramycin Be in the Mix?

During wound closure in definitive fixation surgery for periarticular tibial fractures, topical application of 1 g of vancomycin powder reduced surgical site infections (SSIs) from gram-positive, but not gram-negative, bacteria in a previous open-label randomized trial. Now, in another open-label randomized trial at 39 U.S. trauma centers, researchers assessed whether adding 1.2 g of topical tobramycin powder to 1 g of vancomycin powder during these procedures could reduce postprocedural SSIs, compared with the vancomycin alone. The primary analysis included >1500 participants at high risk for SSIs.