An experimental model for the study of antibiotic penetration and persistence in skeletal hematomas has been described. The highest levels of penicillin in the hematoma and the longest persistence of penicillin in the hematoma occurred when the drug was given before and after the operation. With this regimen, bacteriocidal levels of penicillin were maintained in the hematoma for ten to eleven hours after the last dose.
While penetration of a hematoma with inhibitory levels of penicillin administered within four days of operation has been demonstrated, no conclusions concerning the value of antibiotics in the prophylaxis of operative wound infection are warranted from this study. Further studies on infected hematomas are being done to elucidate that question.