{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:22:40Z","timestamp":1792167760463,"version":"4.4.0"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,4,8]],"date-time":"2018-04-08T00:00:00Z","timestamp":1523145600000},"content-version":"am","delay-in-days":362,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2017,4,11]],"date-time":"2017-04-11T00:00:00Z","timestamp":1491868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000090","name":"Congressionally Directed Medical Research Programs","doi-asserted-by":"publisher","award":["W81XWH\u201014\u20102\u20100010"],"award-info":[{"award-number":["W81XWH\u201014\u20102\u20100010"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p>Heterotopic ossification (HO) is a debilitating sequela of high\u2010energy injuries. It frequently requires surgical excision once symptomatic and there is no practical prophylaxis for combat\u2010injured patients. In this study, we examined the effect of local vancomycin powder on HO formation in a small animal model of blast\u2010related, post\u2010traumatic HO. Male Sprague\u2010Dawley rats were subjected to a polytraumatic extremity injury and amputation with or without methicillin\u2010resistant <jats:italic>Staphylococcus aureus<\/jats:italic> infection. Animals were randomized to receive a single local application of vancomycin (20\u2009mg\/kg) at the time of injury (POD\u20100, <jats:italic>n<\/jats:italic>\u2009=\u200934) or on postoperative day\u20103 (POD\u20103, <jats:italic>n<\/jats:italic>\u2009=\u200911). Quantitative volumetric measurement of ectopic bone was calculated at 12\u2010weeks post\u2010injury by micro\u2010CT. Bone marrow and muscle tissues were also collected to determine the bacterial burden. Blood for serum cytokine analysis was collected at baseline and post\u2010injury. Vancomycin treatment on POD\u20100 suppressed HO formation by 86% and prevented bone marrow and soft tissue infections. We concurrently observed a marked reduction histologically in nonviable tissue, chronic inflammatory cell infiltrates, bone infection, fibrous tissue, and areas of bone necrosis within this same cohort. Delayed treatment was significantly less efficacious. Neither treatment had a marked effect on the production of pro\u2010inflammatory cytokines. Our study demonstrates that local vancomycin treatment at the time of injury significantly reduces HO formation in both the presence and absence of infection, with decreased efficacy if not given early. These findings further support the concept that the therapeutic window for prophylaxis is narrow, highlighting the need to develop early treatment strategies for clinical management. \u00a9 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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