Evaluating Antibiotic Strategies for Severe Open Fractures (SEXTANT 2)

This study is testing two different ways to prevent infections after severe open fractures (when the bone breaks through the skin). You could receive either the standard care for preventing and treating infection, or a new approach called SEXTANT. The SEXTANT approach involves 72 hours of systemic antibiotics (given throughout the body) and applying Vancomycin and Tobramycin directly to the wound during surgery. Researchers want to see if the SEXTANT approach is better at preventing deep surgical site infections (infections that affect the bone or surrounding tissues) within 180 days after your wound is closed. This study is for adults aged 18 to 64 with specific types of severe open tibia, ankle, calcaneus, or talus fractures. The current status of this study is unclear, and it plans to enroll 600 participants.

Study design
This is an interventional study where participants will be randomly assigned to receive either standard care or the SEXTANT experimental protocol. It plans to enroll 600 participants.
What's involved
Not specified in the trial record.
Compensation
Not stated in the trial record.
Follow-up
Participants will be followed for deep surgical site infection for 180 days after final wound closure/coverage, with one-year rates also assessed.

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NCT04678154

Evaluation of a New Strategy for Protocolized Antibiotic Care for Severe Open Fractures: SEXTANT 2

Recruiting
PHASE3Ages 18–64InterventionalTreatment
Major Extremity Trauma Research Consortium
~600 participants
Updated 2026-07-22 on ClinicalTrials.gov
What's tested:Standard of careVancomycin and Tobramycin

At a glance

Recruiting sites
31 of 31 listed sites are recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Deep surgical site infection
Measured over 180 days from final wound closure/cloverage
Post Operative Surgical Site Infection
31 sites across 21 states
California3
North Carolina3
Virginia3
Indiana2
Maryland2
Ohio2
Rhode Island2
Colorado1
  • Micahel J Bosse, MD · PRINCIPAL_INVESTIGATOR · Carolinas Medical Center
  • Rachel Seymour, PhD · PRINCIPAL_INVESTIGATOR · Atrium Health Musculoskeletal Institute Research
  • Renan C Castillo, PhD · PRINCIPAL_INVESTIGATOR · Johns Hopkins Bloomberg School of Public Health
  • Anthony R Carlini, MS · PRINCIPAL_INVESTIGATOR · Johns Hopkins Bloomberg School of Public Health

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  • Deep surgical site infection180 days from final wound closure/cloverage

    To determine if the SEXTANT treatment strategy designed to address the modern wound bioburden at the time of delayed wound closure/coverage is superior to the standard-of-care (SOC) antibiotic protocol. Our primary comparison will be the proportion of fracture-related infections (FRI) under the SEXTANT arm versus the FRI proportion for those under standard of care in the first 180 days following final wound closure/coverage. One-year rates of FRI will also be assessed.