EFFICACY OF HANDMADE ANTIBIOTIC PMMA BEADS IN TREATMENT OF CHRONIC OSTEOMYELITIS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 54
Abstract
BACKGROUND The term osteomyelitis literally implies inflammation of bone and its bone marrow. The infection involves the marrow space, the Haversian system, and the subperiosteal space. The bone is involved secondarily.(1) Chronic osteomyelitis generally cannot be eradicated without surgery, that is sequestrectomy and resection of scarred and infected bone and soft tissue. The hall mark of osteomyelitis is infected dead bone with in a compromised soft tissue envelope. This avascular envelope of scar tissue leaves systemic antibiotic essentially ineffective. Antibiotic impregnated bone cement beads, specifically designed to combat infection localised to bone and soft tissue, have beads, developed to counter these challenges. MATERIALS AND METHODS Study consists of total 40 patients of chronic osteomyelitis treated with PMMA Beads. In our study, all the patients had pus discharge. Mean age for the patients was 30.80 years (10 – 65 years) and male to female ratio was 4.71:1 (Male : 33, female : 7). Most common involved bone was femur (12 patients) followed by tibia (10 patients) and humerus (4 patients). On pus culture, 33 patients had Staphylococcus growth, 4 patients had Streptococci growth while 3 patients’ pus culture showed no growth after 48 hours. Radiologically 26 patients had sequestra with cavity, 14 patients had cavity alone while 12 patients had periosteal reaction. RESULTS In our study, 40 patients with haematogenous chronic osteomyelitis of long bone were tested using handmade, vancomycinimpregnated PMMA beads. At 6 months followup, 34 (85%) patients had good results with clinical and laboratory evidence of healed infection. CONCLUSION Use of antibiotic impregnated PMMA beads offer other advantages that long term parenteral antibiotic therapy is not required, and the patients are not exposed to systemic adverse effects as serum concentration is low and economic savings can be realised as a result of shortened hospital stay, less intensive nursing and reduced use of parenteral antibiotics.
Authors and Affiliations
Abhilekh Mishra, Sameer Gupta
Keywords
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- EP ID EP225798
- DOI 10.14260/Jemds/2017/882
- Views 63
- Downloads 0
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