Decompression Surgery With Antibiotic-impregnated Calcium Sulfate Can Achieve More Satisfactory Results Than Decompression Alone in Pediatric Hematogenous Osteomyelitis

Abstract

BackgroundThe curative effect of antibiotic-impregnated Calcium Sulfate in pediatric ostemyelitis is unknown. The purpose of this study was to compare the outcomes of two treatment methods, decompression combined with antibiotic-impregnated calcium sulfate and decompression alone, for the treatment of pediatric Hemotogenous Osteomyelitis.MethodsBetween 2013 to 2016, forty-one patients with Hematogenous Osteomyelitis met the criteria were included for assessment. Twenty-one patients were included in the calcium sulfate group (the CS group) in which vancomycin and/or gentamicin impregnated calcium sulfate was used as an adjuvant after bone decompression while 20 patients as the control group were undergone bone decompression alone. The infection recurrence rate, hospital stay, wound healing duration, serum inflammatory index, pathological fracture, leakage of the incision ,follow-up time were compared between the two groups.ResultsInfection recurrence was 0% (0/21) in CS group and 15%(3/20) in control group within 12 months(P=0.107). Infection recurrence was 0%(21/21) in CS group and 20% (16/20) of patients at a minimum of 24(range 24 to 67) months follow-up(P=0.048). Mean hospital stay were 8.19(range 3 to 21) days in CS group and 15.95(range 5 to 47) days in control group(P=0.02). Mean wound healing duration were 16.1(range 10 to 29) days in CS group and 15.5(range 10 to 25) days in control group(P=0.65). Serum inflammatory index for WBC(White Blood Cells), ESR( Sedimentation Rate), CRP(C-Reactive Protein) was respectively 8.76(6.03-12.07)*10^9/L, 44.14(26-70)mm/L, 12.35(1.03-35.04) mg/Lin CS group and 8.90(5.68-13.56)*10^9/L, 39.25(19-57)mm/L, 15.65(1.02-45.69) mg/L in control group(P=0.82, P=0.31, P=0.51). Pathological fracture was 0% (0/21) in CS group and 10%(2/20) in control group(P=0.23). Leakage of the incision was 4.76% (0/21) in CS group and 10%(2/20) in control group(P=0.61). ConclusionsAntibiotic-impregnated Calcium Sulfate can reduce infection recurrence and shorten the mean hospital stay in pediatric Hemotogenous Osteomyelitis. The curative effect of antibiotic-impregnated Calcium Sulfate in pediatric ostemyelitis is satisfactory. Trial registrationRetrospectively registered.