Efficacy of Biodegradable Calcium Sulfate Impregnated Gentamycin Beads for the Management of Chronic Osteomyelitis

Vol 32| Issue 2 | July – Dec 2019 | page: 14-19 | Ahamad Shaheel Sultan, Joseph Dickson Olivero


Authors: Ahamad Shaheel Sultan [1], Joseph Dickson Olivero [1]

[1] Department Of Orthopaedics, Govt. Medical College, Kozhikode, Kerala, India.
[2] Department Of Orthopaedics, IQRAA International Hospital Calicut, Kerala, India.

Address of Correspondence

Dr. Raju Karuppal,
Govt. Medical College, Kozhikode, Kerala, India.
E-mail: drrajuortho@rediffmail.com


Abstract

Introduction: Chronic orthopedic infections are always a nightmare not only in developing world but also in developed nations. They will always persist to be a continuing challenge for any orthopedic surgeon. Debridement is the answer and not to sit on any infection neglecting if any. Surgical aim and irrigation are to dilute the bug concentration for a viable vascularized base which helps healing. Local antibiotic delivery system always stood the test of time. The principle involved is achieving a germ-free environment locally, leading to better and faster union of fracture.
Objectives: The objectives of the study were to study the efficacy of biodegradable calcium sulfate impregnated antibiotic beads in treating chronic osteomyelitis and to study any adverse effect of biodegradable calcium sulfate impregnated antibiotic beads in the treatment of chronic osteomyelitis.
Materials and Methods: This is a prospective study conducted in Government T D Medical College Hospital from August 2017 to August 2019.Our sample size of 100 patients was included meeting consenting for the study and meeting inclusion and exclusion criteria. Efficacy of the biodegradable antibiotic beads was measured using the following parameters for all selected patients: (1) Clinical parameters (ASEPSIS scoring system),(2) radiological parameters(Cierny and Mader staging), (3) laboratory parameters(erythrocyte sedimentation rate and C-reactive protein), and (4) culture results (discharge/pus)
Results: There were 75 males and25 females out of 100 selected patients.
Functional Outcome: While comparing clinical, radiological, and laboratory parameters, 80 patients had good results and 20 had bad outcome.
Complication: Product-related discharge in 5 patients, persistence of osteomyelitis in 10 patients, and persistence of non-union in 5 patients.
Conclusion: Local application of antibiotic-impregnated biodegradable calcium sulfate beads has better outcome in the treatment of chronic orthopedic infections.
Keywords: Chronic orthopedic infections, Antibiotic beads, Biodegradable antibiotic beads, Cierny-Mader staging.


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How to Cite this Article: Sultan A S, Olivero J D | Efficacy of Biodegradable Calcium Sulfate Impregnated Gentamycin Beads for the Management of Chronic Osteomyelitis | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 14-19 .

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