General principles

Antibiotic prophylaxis is not routinely required for traumatic wounds that do not require surgical management and are not significantly contaminated. Careful cleaning and debridement is the mainstay of therapy for these wounds.

For wounds that require prophylaxis, combining careful cleaning and debridement with antibiotics reduces the incidence of early infections. Administer antibiotic prophylaxis as soon as possible, ideally within 3 hours of injury.

The duration of prophylaxis depends on injury severity (muscular, skeletal and soft tissue trauma, crush injuries, penetrating injuries, and stab wounds are usually severe), adequacy of debridement and whether soft tissue coverage is achievable.