WHEN IS A PROPHYLACTIC APPLICATION OF ANT IBIOTICS IN TRAUMATOLOGY USEFUL

In situtations where the local host damage (either traumatic or iatrog enically induced) is the predominant co-factor for the development of infection, the antibiotic or other pharmacological reduction of the ba cterial colonisation is of secondary or no importance at all. On the o ne hand, excellent hygienic conditions have reduced more and more the relative importance of the bacterial contamination in aseptic procedur es. On the other hand, the surgical-technical evolution in the last 5 years (such as biological osteosynthesis, unreamed intramedullary nail ing, stepwise procedures in complex fractures, initial open wound trea tment and very early plastic reconstruction in open fractures) could c reate a significant improvement of the conditions concerning preventio n and treatment of infection. Therefore, the relative importance of as sociated antibiotic treatment has to be considered to be essentially l ower.