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Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_2 | Pages 83 - 83
1 Feb 2020
Wolff D Newman J Shah N Morrissey P Conway C Gold R Tretiakov M Sedaghatpour D Pivec R Naziri Q Illical E
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Purpose

Infections in orthopaedic surgery are costly, debilitating complications. The search for new treatments and prevention strategies has led to the use of antibiotic-filled calcium sulfate (CaS) as a bone void filler that is both safe and effective. The purpose of this study was to examine the available data on the efficacy of this technology.

Methods

A literature search was performed for studies that evaluated the use of antibiotic-loaded CaS cement in orthopaedics published between inception of the databases to 2017. Selected studies included randomized controlled trials (RCTs) and observational studies published in the English language that met the following criteria: 1) patients underwent an orthopaedic procedure; 2) CaS cement with an antibiotic was used; and 3) at least one of our outcomes were mentioned. Outcomes included resolution of infection, complications related to treatment, subsequent surgeries, overall infection rate, fracture union rate, clinical outcomes, and wound complications. A total of 17 studies were included.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 81 - 81
1 Mar 2006
Wolff D Militz M Buehren V
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Purpose: Chronic posttraumatic osteomyelitis of the femur is still a great challenge for medical treatment. Bacterial colonization after multi-fragment fractures often complicates and extends bone healing. Muti-modal management including hyperbaric oxygenotherapy and frequent lavage and debridement as well as use of systemically and locally applied antibiotics are needed to eradicate infection.

This study introduces our treatment regime for chronic posttraumatic osteomyelitis of the femur and presents our results.

Material and Method: We reviewed 24 patients with posttraumatic osteomyelitis after femoral shaft fractures treated at our trauma center. We analyzed the bacterial spectrum, changes in bacterial spectrum during treatment, numbers of operative revisions and hyperoxygenotherapy cycles, as well as over all hospitalisation time, and outcome concerning bone healing.

Results: Staphylococci were the most frequently found bacteria at first revision, followed by Enterobacter species. Average length of treatment was 8.3 (1–29) months.

An average of 11.5 (2–32) operative revisions including intramedullar debridement were performed, additionally 10 patients underwent a mean of 29 (3–81) hyperoxygenotherapy cycles.

Re-Infection after treatment occured in 7 cases, in 2 patients amputation was needed to eradicate infection.

Conclusions: Our results show, that the chronic post-traumatic osteomyelitis of the femur is an insistent disease that needs to be treated interdisciplinary over a long period of time. Our treatment regime produces satisfying results. Individual solutions are necessary to reach an infection-free status.