Off-label Usage of Absorbable Beads Containing Antibiotics for Prevention of Surgical Site Infections

Trujillo, Jeffrey M; Logue, Mary E.; Kunkel, Ryan; Demas, Christopher

doi:10.25270/wnds/2017.10.289296e84e87

Cited by 10 publications

(10 citation statements)

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“…On this basis, we encourage early referral to a specialist team and have a low threshold for early surgical intervention and local antibiotic-loaded administration, ensuring a more direct route to help preserve structure and function and prevent amputation. We have also used this method for prophylaxis in patients with high predilection for infection in foot surgery, which has been shown to be previously effective (43).…”

Section: Systemic Postoperative Antibioticsmentioning

confidence: 99%

Complex Foot Infection Treated With Surgical Debridement and Antibiotic Loaded Calcium Sulfate—A Retrospective Cohort Study of 137 Cases

Morley

Rothwell

Stephenson

et al. 2022

The Journal of Foot and Ankle Surgery

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Section: Systemic Postoperative Antibioticsmentioning

confidence: 99%

Complex Foot Infection Treated With Surgical Debridement and Antibiotic Loaded Calcium Sulfate—A Retrospective Cohort Study of 137 Cases

Morley

Rothwell

Stephenson

et al. 2022

The Journal of Foot and Ankle Surgery

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“…12,16 Other potential benefits include filling of tissue voids, and possible prevention of biofilm formation. [17][18][19] In joints, the reports on CSB utilisation have been mixed. Preliminary studies have documented low reinfection rates with these beads, but the side effects may include heterotopic ossification and wound drainage.…”

Section: Utilisation Of Calcium Sulphate Beads In One-stage Aseptic R...mentioning

confidence: 99%

Utilisation of calcium sulphate beads in one-stage aseptic revision total hip arthroplasty

et al. 2020

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Introduction: Periprosthetic joint infection (PJI) affects many revision total hip arthroplasty (THA) patients, contributing to a concomitant rise in revision costs. Means of decreasing the risk of PJI include the use of antibiotic adjuncts, such as calcium sulphate beads (CSBs). Mixed with antibiotics, the potential benefits of CSBs include dissolvability and antibiotic drug elution. However, information comparing them in aseptic revision is scarce. Therefore, this study investigated CSB utilisation for infection prevention in aseptic revision THA. Specifically, we compared (1) infection rates; (2) lengths of stay; (3) subsequent infection procedures; and (4) final surgical outcome in 1-stage aseptic revision THA patients who did received CSBs to 1-stage aseptic revision THA patients who did not. Methods: A retrospective chart review was performed to identify all patients who underwent an aseptic revision THA between January 2013 and December 2017. Patients who received CSBs ( n = 48) were compared to non-CSB patients ( n = 58) on the following outcomes: postoperative infections, lengths of stay (LOS), subsequent irrigation and debridements (I+Ds), and final surgical outcome, classified as successful THA reimplantation, retained antibiotic spacer, or Girdlestone procedure. Chi-square and t-testing were used to analyse the variables. Results: There was no significant differences found between CSB patients and non-CSB patients in postoperative infections ( p = 0.082), LOS ( p = 0.179), I+Ds ( p = 0.068), and final surgical outcome ( p = 0.211). Conclusion: This study did not find any statistical difference between CSBs and standard of care in infection rates and surgical outcomes. The advantage of these beads for 1-stage aseptic revisions is questionable.

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“…The use of antibiotic-impregnated calcium sulfate beads has been reported in the arthroplasty and foot and ankle literature for the treatment of peri‑prosthetic infections [11 , 12] . This option may be preferable to antibiotic-impregnated beads composed of polymethylmethacrylate compounds, as calcium sulfate beads do not require subsequent surgical removal [13 , 14] . Furthermore, studies of vancomycin-impregnated calcium sulfate beads have demonstrated in vitro levels above 1000 ug/mL as far as 35 days out from surgery [15] , and in vivo levels above the minimum inhibitory concentration (MIC) for as long as three months postoperatively [16] .…”

Section: Introductionmentioning

confidence: 99%

Vancomycin-impregnated calcium sulfate beads compared with vancomycin powder in adult spinal deformity patients undergoing thoracolumbar fusion

Xiong

Fogel

Tobert

et al. 2021

North American Spine Society Journal (NASSJ)

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Introduction Adult spinal deformity (ASD) surgery patients are at higher risk for surgical site infections (SSIs) due to large incisions, high blood loss, long surgical duration, and extensive instrumentation. The use of vancomycin powder has demonstrated inconsistent results in ASD surgery. Antibiotic-impregnated calcium sulfate beads have been used in arthroplasty and foot and ankle surgery with promising results. The purpose of this study was to provide preliminary data on the use of vancomycin-impregnated calcium sulfate beads in the prevention of SSI following ASD surgery and provide comparisons to the use of vancomycin powder. Methods A retrospective chart review was performed for 95 consecutive surgical ASD patients at a tertiary care center from January 2017 until March 2020. Patients received either vancomycin powder (powder group) or vancomycin-impregnated calcium sulfate beads (bead group) intrawound prior to closure. Patient demographics, operative course, and incidence of postoperative infections were recorded. A two-tailed chi-squared test was performed to compare infection rates. Results Ninety-five patients were included for review. Forty-two patients were in the powder group and 53 patients were in the bead group. The bead group was older (59.8 vs 67.8 years, p < 0.01) with similar BMI and rates of diabetes, smoking, and length of surgery. There were four postoperative SSI in the powder group requiring operative irrigation and debridement and one SSI in the bead group (9.5% vs 1.9%, p = 0.09). All infections occurred in the first 90 days of the postoperative period. Conclusion Preliminary examination of the use of vancomycin-impregnated calcium sulfate beads demonstrated a 1.9% surgical site infection rate in adult spinal deformity surgical patients, which was not significantly different compared with the 9.5% infection rate in patients who received vancomycin powder. Prospective study is needed to determine if the differences found are significant in a larger number of patients.

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Off-label Usage of Absorbable Beads Containing Antibiotics for Prevention of Surgical Site Infections

Cited by 10 publications

References 0 publications

Complex Foot Infection Treated With Surgical Debridement and Antibiotic Loaded Calcium Sulfate—A Retrospective Cohort Study of 137 Cases

Complex Foot Infection Treated With Surgical Debridement and Antibiotic Loaded Calcium Sulfate—A Retrospective Cohort Study of 137 Cases

Utilisation of calcium sulphate beads in one-stage aseptic revision total hip arthroplasty

Vancomycin-impregnated calcium sulfate beads compared with vancomycin powder in adult spinal deformity patients undergoing thoracolumbar fusion

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