The prevention of experimental osteomyelitis in a model of gunshot fracture in the pig

Data from civilian trauma practice would support the non-operative management of low-energy transfer ballistic wounds to bone. However, there is a paucity of data to indicate whether this would be an effective treatment for similar injuries in military casualties, in whom wounds are heavily contaminated and there is a delay to receipt of medical treatment. We created a model of ballistic wounding in the proximal tibia of pigs. Fractures were contaminated withStaphylococcus aureus. Animals were divided into two groups; Control (n = 8), received no treatment, Treatment (n = 6), received 600 mg benzylpenicillin and 500 mg flucloxacillin by intramuscular injection for seven days, commencing six hours after injury. Animals were killed 14 days after injury. Treatment with antibiotics caused a statistically significant reduction in the incidence of osteomyelitis assessed by bacteriological examination. The results have important implications for the management of low-energy transfer wounds of bone in both civilian and military casualties.