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Objectives. The purpose of this study was to refine an accepted contaminated
rat femur defect model to result in an infection rate of approximately
50%. This threshold will allow examination of treatments aimed at
reducing infection in open fractures with less risk of type II error. Methods . Defects were created in the stablised femurs of anaethetised
rats, contaminated with Staphylococcus aureus and
then debrided and irrigated six hours later. After 14 days, the
bone and implants were harvested for separate microbiological analysis.
This basic model was developed in several studies by varying the
quantity of bacterial inoculation, introducing various doses of
systemic antibiotics with and without local antibiotics. Results . The bacterial inoculation associated with a 50% infection rate
was established as 1 × 10. 2. colony forming units (CFU). With
an initial bacterial inoculum of 1 × 10. 5. CFU, the dose
of systemic antibiotics associated with 50% infection was 5 mg/Kg
of cafazolin injected sub-cutaneously every 12 hours, starting at
the time of the first debridment and continuing for 72 hours (seven
doses). The systemic dose of cafazolin was lowered to 2 mg/Kg when
antibiotic polymethyl methacrylate beads were used concurrently
with the same amount of bacterial inoculation. Conclusion. This model of open fracture infection has been further refined
with potential for local and systemic antibiotics. This is a versatile
model and with the concepts presented herein, it can be modified
to evaluate various emerging therapies and concepts for open fractures. Cite this article: Bone Joint Res 2014;3:187–92