A severe traumatic injury to the extremity is at risk to become infected due to the type of trauma sustained. Most often the injury involves soft tissue (skin and muscle) loss, and commonly there is debris such as dirt in the wound. 

Surgical debridement (removal) of the foreign material as well as tissues damaged during the injury is important in managing any possibility of infection. In addition, antibiotics are utilized to control any possible infection. The antibiotics may be given orally, intravenously, or by placing the antibiotics directly in the wound - or all three routes.

Common approaches to placing the antibiotics directly in the wound are:

• antibiotic cement spacers
• antibiotic beads or pellets
• internal fixation coated with antibiotic impregnated cement

Cultures of the area are frequently obtained to determine if an infection is occurring, and if there is an infection, what organism.  By monitoring the wounds the infectious disease specialists can best determine the antibiotic to use to control the infection. Every effort is made to control an infective process prior to the final reconstructive effort by the orthopedic and plastic surgeons.

Antibiotic beads prior to use	Antibiotic pellets and antibiotic cement (blue) in a patient's leg wound.