OTA Survey – Antibiotic use in fractures from low-velocity gunshots

  1. What is your practice setting?
  2. Level 1 trauma center (with residents/fellows)
  3. Level 1 trauma center (without residents/fellows)
  4. Level 2 trauma center (with residents/fellows)
  5. Level 2 trauma center (without residents/fellows)
  6. Other community hospital
  1. Did you do a fellowship?
  2. Yes, in orthopaedic trauma
  3. Yes, in another specialty
  4. No
  1. How many years have you been in practice?
  2. 0-5 years
  3. 6-10 years
  4. 10-20 years
  5. > 20 years
  1. How many fractures caused by gunshots do you treat each year?
  2. 0 – 5
  3. 6 - 10
  4. 10 – 20
  5. >20
  1. What percentage of these fractures are caused by low energy weapons?
  2. 0%
  3. 1 – 50%
  4. 51 – 75%
  5. 76 – 95%
  6. 96 – 100%
  1. In your experience, would you consider wounds from low-velocity weapons to be low-energy injuries?
  2. Never
  3. Sometimes
  4. Usually
  5. Always
  1. Do you feel the Gustilo and Anderson classification of open fractures applies to low-velocity gunshot fractures?
  2. Yes
  3. No
  1. Does your institution have a policy in place for antibiotic use in low-velocity gunshot fractures?
  2. Yes
  3. No
  1. Does your department/practice have a policy in place for antibiotic use in low-velocity gunshot fractures?
  2. Yes
  3. No
  1. Do you routinely provide antibiotic prophylaxis for low-velocity gunshot fractures?
  2. Yes
  3. No
  1. If yes, please select the fractures for which you use antibiotics (select all that apply)
  2. All fractures caused by low-velocity gunshots
  3. Intraarticularfracture in the appendicular skeleton
  4. Extraarticularfracture in the appendicular skeleton
  5. Lower extremity above the knee to extra-capsular hip
  6. Lower extremity below the knee to the ankle
  7. Foot/ankle
  8. Upper extremity above the elbow to surgical neck humerus
  9. Upper extremity below elbow to radial metaphysis
  10. Wrist/hand
  11. Pelvic, no visceral injury
  12. Pelvic, visceral injury
  13. Operative fractures (in addition to standard preoperative antibiotics)
  14. Nonoperative fractures
  1. If you prescribe antibiotics, for how long do you provide prophylaxis?
  2. Single dose
  3. <=24 hours
  4. 24 – 48 hours
  5. 48 – 72 hours
  6. > 72 hours
  1. If you prescribe antibiotics, how do you administer them?
  2. PO administration for the duration of treatment
  3. 1 dose IV, followed by PO for the duration of treatment
  4. 24 hours of IV, followed by PO for the duration of treatment
  5. IV administration for the duration of treatment
  1. Assuming no patient allergies, what antibiotics do you generally use?
  2. 1st generation cephalosporin (e.g. cefazolin)
  3. 1st generation cephalosporin and aminoglycoside (e.g. gentamicin)
  4. Vancomycin
  5. Fluoroquinolone (e.g. Ciprofloxacin)
  6. Clindamycin
  7. Zosyn
  1. Do you base your antibiotic choices on the Gustilo and Anderson classification of open fractures?
  2. Yes
  3. No
  1. If you do provide antibiotic prophylaxis for low-velocity gunshot fractures, what are your reasons (select all that apply)?
  2. Literature supports it
  3. Personal preference
  4. Was trained to in residency/fellowship
  5. Fear of litigation
  6. Institutional protocols
  7. Practice/department protocol
  8. Other
  1. If no, do you vary your choice of antibiotic by location of injury?
  2. Yes
  3. No
  1. If so, please select the fractures for which you use antibiotics (select all that apply)
  2. All fractures caused by low-velocity gunshots
  3. Intraarticular fracture in the appendicular skeleton
  4. Extraarticular fracture in the appendicular skeleton
  5. Lower extremity above the knee to extra-capsular hip
  6. Lower extremity below the knee to the ankle
  7. Foot/ankle
  8. Upper extremity above the elbow to surgical neck humerus
  9. Upper extremity below elbow to radial metaphysis
  10. Wrist/hand
  11. Pelvic, no visceral injury
  12. Pelvic, visceral injury
  13. Operative fractures (in addition to standard preoperative antibiotics)
  14. Nonoperative fractures
  1. If you do NOT provide antibiotic prophylaxis for low-velocity gunshot fractures, what are your reasons (select all that apply)?
  2. Literature does not support it
  3. Personal preference
  4. Was trained not to in residency/fellowship
  5. Cost
  6. Fear of resistance
  7. Institutional protocol
  8. Practice/department protocol
  9. Other