Clinical Research Directory

Inclusion Criteria: * 18 years or older at time of surgery * Patients with an open fracture classified as Gustilo Type I to IIIc in the clavicle, humerus, radius, ulna, metacarpals, upper extremity phalanges (fingers), femur, tibia, fibula and metatarsals and lower extremity phalanges (toes). * Open fracture treated operatively with plate(s) and screw(s) hardware fixation and intramedullary fixation (IM nail). * Able to attend standard of care follow up for six months post-operatively Exclusion Criteria: * Patients with known vancomycin allergy, drug administration reaction, or other sensitivities to vancomycin. * Patients who have already had definitive fracture fixation before enrollment in the study * Patients with open fracture already infected at time of enrollment * Patients with current positive blood cultures (bacteremia) at time of enrollment (current, meaning they have not received treatment and now have negative most-recent blood cultures). * Patients who have other forms of local antibiotics that are left in place at the end of the definitive fixation surgery (e.g., antibiotic loaded cement or polymethyl methacrylate (PMMA) beads) * Patients who do not speak English * Patients who are currently pregnant * Patients who are unable to provide consent and do not have a substitute decision maker able to provide consent * Patients who will have severe difficulty with follow up