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The Orthopod

The Official Publication of the
American Osteopathic Academy of Orthopedics

    • Leadership Messages
      • President’s Message
      • Executive Director’s Update
      • AOAO President Fred McAlpin’s Acceptance Speech
    • Membership News
      • In Memoriam: Marie Morris
      • Congratulations to the 2020 Award Recipients
      • AOAO Female Orthopedic Group Becomes Section
      • Photo Galleries
    • Residents & Students
      • Introducing the 2020-2021 National SAOAO Executive Board
      • The Virtual Orthopedic Interview (COVID-19 Edition)
    • General Articles
      • What Does it Mean to be a Fellow of the Academy?
      • AOAO Foundation at Work in 2020
    • Abstracts
      • Case Report: Severe Bilateral Genu Valgum in a 32-year-old Active Male with Osteoarthritis Treated with a Step-cut Rotational Distal Femoral Osteotomy
      • Local Application of Doxycycline Powder in Surgical Site: Evaluation of Healing Response, Outcomes and Adverse Events

Abstracts

Local Application of Doxycycline Powder in Surgical Site: Evaluation of Healing Response, Outcomes and Adverse Events

Troy Morrison, DO; Braeden Arnold, OMS IV
Citizens Memorial Hospital, Bolivar, MO; Kansas City University of Medicine and Biosciences, Kansas City, MO

Background
Both oral and topical doxycycline have been shown to have positive therapeutic effects when used in wounds; however, no studies have assessed adverse events, healing and anti-inflammatory effects, and workability of intrawound doxycycline when used in total joint replacement and spine surgery.

Methods
This retrospective cohort study assessed two groups of patients that underwent total joint replacement or spine surgery: those who received intrawound doxycycline powder and those who did not. Outcomes were analyzed between the group that received intrawound doxycycline and the group without intrawound doxycycline using the two-sample t-test for continuous variables and the chi-square test with Fischer’s P value for categorical variables.

Results
The study included 75 patients in the no-intrawound doxycycline group and 60 in the intrawound doxycycline group. Baseline characteristics between each group were non-significant (table 1). There were no significant differences post-operatively when assessing post-operative WBC, post-operative day 1 erythema, post-operative day 1 swelling, incisional blistering, wound dehiscence, wound healing at 2 weeks, emergency room visits, readmissions, and reoperations (table 2).  The post-operative albumin was significantly lower in the doxycycline cohort.

Discussion
Our study found minimal differences in outcomes between patients without intrawound antibiotic and intrawound doxycycline patients that underwent orthopedic surgical procedures. The study did not find a significant difference between the healing rate of the control cohort and the intrawound doxycycline cohort; however, we recognize that more studies are needed to evaluate the use of doxycycline due to the limited number of studies published. We hypothesize the significant decrease between the pre- and post-operative albumin levels is an incidental finding as hepatotoxicity caused by doxycycline is a rare occurrence and no patient during the present study presented with signs or symptoms of liver abnormalities. Finally, we concluded that of the emergency room visits, readmissions, and reoperations reviewed, a large proportion a result of a fall, are likely due to natural issues that arise with older age as doxycycline to our knowledge is not associated with an increase in falls.

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October 28 – 30, 2021
Omni Louisville | Louisville, KY


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About the Orthopod

The Academy’s e-newsletter is published three times annually.

Editor:
Steven J. Heithoff, DO, FAOAO
Orthopodeditor@aoao.org

Contributors:
Kyle J. Busch, DO, MS PGY-5
Adam LaFleur
James S. Mason, DO, FAOAO
Fred McAlpin, III, DO, FAOAO
Gary S. Ulrich, DO, FAOAO, FACOS

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