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A 24-year-old male presents following a motorcycle crash with an isolated injury to his right lower extremity. He has a 3x2cm wound over the fracture site, and he immediately receives Gram positive and Gram negative coverage along with a tetanus booster. The patient is splinted, optimized, and brought to the operating room where the wound is debrided and classified as a Type IIIB fracture. Deemed stable, the plastic surgery team arrives and acutely performs a free flap for coverage, following definitive fixation with an intramedullary nail. All of the following are factors that have been shown to increase infection risk EXCEPT:
Time to antibiotic administration
Thoroughness of debridement
Time to initial debridement
Ability to close/cover an open wound
Time to definitive fixation
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A 25-year-old male presents to the emergency department after a lawnmower accident with traumatic loss of his great toe. On examination, his wound is grossly contaminated with soil. In addition to a cephalosporin and an aminoglycoside, penicillin is given. Which of the following is true with regards to the organism that penicillin is targeting in this injury?
It is an Aerobic, Gram-positive rod
It is an Anaerobic, Gram-positive coccus
It is an Anaerobic, Gram-negative rod
It is Catalase positive
It may cause botulism
A 43-year-old male sustains the injury shown in Figure A. He has an overlying 3 centimeter wound with exposed bone. Which of the following antibiotics is indicated for initial prophylaxis?
A 25-year-old male involved in a motorcyle accident sustains the injury seen in Figures A and B. After initial adequate debridement of nonviable tissue, which of the following irrigation methods and devices should be used?
Antibiotic solution applied by low pressure gravity flow device
Antibiotic solution applied by high pressure pulsatile flow device
Saline solution applied by low pressure gravity flow device
Saline solution applied by high pressure pulsatile flow device
Antibiotic solution applied by high pressure pulsatile flow device followed by low pressure gravity flow device
A 27-year-old man sustains a Gustilo and Anderson type II open tibia fracture during a motorcycle accident. He had a full course of tetanus vaccination as an infant and child. He also had a tetanus booster vaccination 12 months ago when he began a new job. In addition to intravenous antibiotics, what tetanus prophylaxis should be administered?
No prophylaxis required
Tetanus immune globulin
Tetanus vaccine and tetanus immune globulin
Tetanus vaccine and tetanus immune globulin with a booster vaccine required 6 months from now