Vancomycin Tissue Concentrations by Bier Block or Intravenous Administration

Mayo Clinic20 enrolled

Overview

The purpose of this study is to determine whether or not giving a lower dose of antibiotics (Vancomycin) in the area where it is needed (upper extremity) is more effective at preventing infection than the current standard dose which is given intravenously (IV).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Infection Hand Injury Wrist Hand Injuries Hand Injuries and Disorders Hand Arthritis

Interventions

Systemic IV VancomycinDRUG

1 g of vancomycin will be delivered intravenously over a period of one hour prior to tourniquet inflation.

Bier BlockPROCEDURE

After exsanguination of the limb and elevation of the tourniquet in the prepped and draped patient, Vancomycin will be injected into a superficial vein in the hand, wrist or forearm.

VancomycinDRUG

500 mg diluted in 50 cc normal saline of injection into superficial vein in the hand, wrist or forearm

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients undergoing upper extremity reconstruction by a single surgeon. * Surgical cases will include: * Trapeziectomy/suspensionplasty. * PIPJ/MPJ arthroplasty. * Proximal row carpectomy. * Distal ulnar resection. * Distal radius fracture fixation. Exclusion Criteria: * Inability to adequately cannulate a superficial vein in the upper extremity within 5 minutes of tourniquet inflation. * Evidence of subcutaneous extravasation in Bier block group. * History of renal dysfunction. * Vancomycin allergy. * ASA\>/= 3. * History of lung cancer. * Known HIV infection. * History of organ transplantation.

Locations (1)

Mayo Clinic in Arizona

Phoenix, Arizona, United States

Outcomes

Primary Outcomes

Tissue concentrations of vancomycin

Tissue concentrations of vancomycin in the hand and wrist following Bier Block administration versus systemic IV administration

Time frame: Approximately 45-60 minutes after skin incision

Secondary Outcomes

Adverse Events

Number of adverse events reported for Bier Block administered vancomycin

Time frame: 1 year

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.