Limb salvage or amputation? The use of a gentamicin coated nail in a severe, grade IIIc tibia fracture

Raschke, Michael J.; Wähnert, Dirk; Fuchs, Thomas

doi:10.1007/s00068-010-0017-x

Cited by 20 publications

(16 citation statements)

References 19 publications

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“…Antibiotics, such as gentamicin [46, 63–66] and vancomycin [67, 68], can be mixed in the liquid phase of calcium phosphate cement, HA, or β-TCP [46] against S. aureus and MRSA. The apatite cements are made up of microcrystals that have a better biological performance in size and formation than HA particles [63], and show better antibacterial activity.…”

Section: Main Components Of Coating For Irismentioning

confidence: 99%

“…In a prospective, non-randomized case series, Fuchs et al investigated the outcomes of 21 patients underwent surgical treatment with the gentamicin-loaded coating of an implant (UTN PROtect), and no implant-related infections occurred [133]. A 17-year-old man with grade IIIc tibial fractures was also treated by UTN-PROtect and has been successfully limb salvaged instead of prolonged external fixation or amputation which were the standard treatment [66]. Silver coated on the implant surface (Mutars® tumor endoprosthesis (Implantcast, Buxtehude, Germany)) reduced the infection rate from 17.6 to 5.9% in patients with bone sarcoma [134].…”

Section: Evidence Of the Anti-infective Prophylactic Therapy Of Coatingmentioning

confidence: 99%

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Coatings as the useful drug delivery system for the prevention of implant-related infections

Pan

Zhou

2018

J Orthop Surg Res

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Implant-related infections (IRIs) which led to a large amount of medical expenditure were caused by bacteria and fungi that involve the implants in the operation or in ward. Traditional treatments of IRIs were comprised of repeated radical debridement, replacement of internal fixators, and intravenous antibiotics. It needed a long time and numbers of surgeries to cure, which meant a catastrophe to patients. So how to prevent it was more important than to cure it. As an excellent local release system, coating is a good idea by its local drug infusion and barrier effect on resisting biofilms which were the main cause of IRIs. So in this review, materials used for coatings and evidences of prevention were elaborated.

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Section: Main Components Of Coating For Irismentioning

confidence: 99%

Section: Evidence Of the Anti-infective Prophylactic Therapy Of Coatingmentioning

confidence: 99%

Coatings as the useful drug delivery system for the prevention of implant-related infections

Pan

Zhou

2018

J Orthop Surg Res

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“…Trotz der kurzen Nachuntersuchungszeit von 6 Monaten überzeugten die klinischen Ergebnisse, insbesondere im Hinblick auf die Prävention von implantatassoziierten Infektionen bei offenen Frakturen. In einer weiteren Einzelfallstudie wurde der UTN PROtect erfolgreich in der Therapie einer offenen Tibiafraktur (Grad III c nach Gustillo) verwendet und bestätigte den klinischen Nutzen in hochkontaminierten Frakturen [10].…”

Section: Merkeunclassified

Antibiotikabeschichtete Implantate in der Unfallchirurgie

Haubruck¹,

Schmidmaier²

2017

OP-JOURNAL

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In der operativen Versorgung von Frakturen stehen in den meisten Fällen anatomisch präformierte Implantate zur Verfügung. Vorteile der intrakorporalen Implantate stellen u. a. die hohe subjektive Patientenakzeptanz, die vereinfachte postoperative frühfunktionelle Mobilisation sowie die problemlosere Rückkehr in die Aktivitäten des Alltags dar.Perioperative implantatassoziierte Infektionen eines intrakorporalen Implantats können jedoch eine schwerwiegende Komplikation für die behandelten Patienten bedeuten. Merke

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“…20,24,25 Antibiotic-coated implants bear significant potential in the treatment of all patients at risk of developing implantrelated infections, such as revision surgeries after failed treatments, nonunions, or in patients with a history of infection or multiple previous operations. However, all data collected so far confirm the fact that the antibiotic coating has no negative side effects on bone healing.…”

Section: Raschke Et Almentioning

confidence: 99%

“…20 This addresses the first step in the chain of colonization, biofilm formation, encapsulation, and finally infection, which can occur upon the implantation of a foreign body. 24,25 Since 2011, a tibial nail of the latest generation design with the same coating is available (Expert Tibial Nail PROtect; Synthes GmbH) and is being used on a broader scale. Implants coated with this poly(D,Llactide) coating containing gentamicin-sulfate were inserted into the medullary canal previously inoculated with bacteria.…”

mentioning

confidence: 99%

Gentamicin-coated Tibia Nails

Raschke

Roßlenbroich

Fuchs

2014

Techniques in Orthopaedics

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The operative treatment of fractures has made enormous progress over the last decades. Nevertheless, fracture treatment remains a challenge for surgeons, and in particular, the more complicated fractures still harbor the potential for complications that cannot be underestimated. To improve prophylaxis against bacterial colonization of the implant surface, local delivery of antibacterial substances is an effective and promising option. In recent years, a fully resorbable coating for intramedullary nails was developed for the delivery of active substances such as antibiotics to the implantation site. This coating leads to antibiotic concentrations well above the minimal inhibitory concentration of the most commonly encountered bacterial strains in the immediate surroundings of the implant. On the basis of promising data from animal studies, an intramedullary tibial nail with antibiotic coating was developed and approved for clinical use in European countries. The first such implant (UTN PROtect) was released in 2005 and subsequently investigated in a prospective case series, where it proved to be an useful tool in the treatment of tibial fractures in patients presenting a higher risk of developing implantrelated infections. Since 2011, a tibial nail of the latest generation design with the same coating is available (Expert Tibial Nail PROtect) and is being used on a broader scale.

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Limb salvage or amputation? The use of a gentamicin coated nail in a severe, grade IIIc tibia fracture

Cited by 20 publications

References 19 publications

Coatings as the useful drug delivery system for the prevention of implant-related infections

Coatings as the useful drug delivery system for the prevention of implant-related infections

Antibiotikabeschichtete Implantate in der Unfallchirurgie

Gentamicin-coated Tibia Nails

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