Abstract
Implant materials impregnated with antibiotics have long been used to manage the dead space created by debridement surgery in patients with osteomyelitis.
To present our preliminary results and in vivo response of patients to PerOssal used to treat bone infection in the form of long bone chronic osteomyelitis. PerOssal is a new osteoconductive bone substitution material for bone filling which consists of an entirely synthetically produced, nanocrystalline hydroxyapatite and calcium sulfate. It can be used effectively as a local antibiotic carrier for the reconstruction of infected bone defects.
We have treated 19 patients with long bone osteomyelitis (15 tibial, 4 femoral) with PerOssal impregnated with the appropriate antibiotic which was used following radical debridement surgery. In all cases we did not rely solely on the mechanical stability that it may provide but we supported the bone when necessary. Postoperative observations were focused on primary wound healing and clinical eradication of infection.
We had: 15 eradication of infection, 2 recurrences, in terms of re-infection by different species or amputation, and 2 on-going cases. Declining wound leakage and delayed wound healing was present in 5 cases where PerOssal was used either intramedullarily but not sealed or extraosseously in relatively large amounts.
We have so far good results with respect to infection control. PerOssal seems to perform better when used in contained defects whereas extraosseous use seems to predispose to prolonged leakage and compromised wound healing or breakdown. The mechanical stability that it provides remains under consideration.
Correspondence should be addressed to Anastasia C. Tilentzoglou MD, General Secretary of the Board of Directors of HAOST, 20 A. Fleming Str. (N.Filothei), Gr. 15123 Maroussi, Athens Greece. E-mail: info@eexot.gr
