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Children's Orthopaedics

GENTAMYCIN-COLLAGEN SPONGE FOR TREATMENT OF BONE INFECTION; SHORT- AND INTERMEDIATE-TERM RESULTS

Combined British Limb Reconstruction Society (BLRS) & British Society for Children's Orthopaedic Surgery (BSCOS) AGM & Instructional Course – additional abstracts.



Abstract

Aim

A prospective study to report the results of using gentamycin-collagen in the surgical treatment of osteomyelitis.

Materials and Methods

After complete radiological and laboratory studies, empirical systemic Imipenem antibiotic was started pre-operatively followed by radical operation and implantation of Collatamp-EG®. Bone defects were treated with iliac or composite ceramic bone graft. Primary or secondary soft tissue reconstructive procedures were used. Closed gravitational suction drainage was used. Parental systemic antibiotics were continued for 2–3 weeks according to culture sensitivity results followed by oral therapy for another 4 weeks. Cattaneo et al scoring system was used to evaluate the final bony and functional results.

Results

The mean number of Collatamp-EG® sponges implanted per patient were 3.6 and the mean follow-up period was 3.8 years. 85.7% of patients had showed positive cultures and staphylococcus aureus was the commonest cultured organism. The following complications were reported; pathological fracture (1), malnuion (2), nonunion (1). According to Cattaneo et al scoring system, bone healing was achieved in 94.4% of patients; bone infection control without relapse was achieved in 100% of patients. 89.2% of patients had complete functional recovery.

Conclusions

Local antibiotic delivery system seems to be a useful and safe component in the armamentarium of the orthopedic surgeon dealing with bone infection by maximizing the local concentration while minimizing their systemic toxicity. Collatamp-EG® help bone and soft tissue repair without the need to remove it.