Septopal Beads and Autogenous Bone Grafting for Bone Defects in Patients With Chronic Osteomyelitis

Patzakis, Michael J.; Mazur, Kai U.; Wilkins, Jeanette; Sherman, Randolph; Holtom, Paul

doi:10.1097/00003086-199310000-00016

Cited by 72 publications

(49 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The treatment of chronic osteomyelitis with sequential debridement and bead application followed by autogenous bone grafting was reported by Patzakis et al [18]. There was no recurrence in 12 patients treated with septopal beads and 5 days of systemic antibiotic therapy.…”

Section: Discussionmentioning

confidence: 92%

“…High local levels of antibiotics provide sufficient antibiotic levels in avascular areas by diffusion, and in many circumstances the organisms that are resistant to drug concentrations achieved by systemic antibiotics are susceptible to the extremely high local drug concentrations provided by local antibiotic delivery [10]. Most of the data reported in the literature supports the safe usage of antibiotic-impregnated beads [4,7,10,11,15,18,20,22]. This system is superior in terms of antibiotic concentration to suction-antibiotic irrigation systems, more convenient to the patient and not associated with the risks of superinfection and blood loss by drains [1].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cierny-Mader Type III chronic osteomyelitis: the results of patients treated with debridement, irrigation, vancomycin beads and systemic antibiotics

Kınık

Karaduman

2007

International Orthopaedics (SICO

View full text Add to dashboard Cite

Cierny-Mader (C-M) Type III osteomyelitis is defined as a localised lesion with both medullary and cortical involvement that is stable mechanically after debridement. The treatment of C-M Type III osteomyelitisis is difficult and requires a precise protocol to achieve a disease-free longterm follow-up. We report here the results of our study on 26 patients (19 men and 7 women; average age: 34.7 years) with C-M Type III osteomylelitis who were treated with radical debridement, irrigation, vancomycin-impregnated custom-made beads and culture-specific systemic antibiotics. Those patients with metaphyseal involvement were treated with deroofing of the cortex and debridement by means of a "trough" (16 patients); those with diaphyseal involvement were treated with both intramedullary reaming and debridement from a trough (ten patients). Antibiotic cement rods were used as an additional therapy in five patients with diaphyseal involvement. Recurrence developed in three patients and was attributed to inadequate debridement; all three patients were treated again in the same manner with success. The mean follow-up is currently 3.6 years (range: 2-6 years). All of the patients have normal clinical, radiographic and laboratory parameters, and all are ambulatory and have returned to their pretreatment level of activity or better. We conclude that C-M Type III chronic osteomyelitis can be safely treated with this protocol.Résumé L'ostéomyélite de type III Cierny-Mader (C-M) peut se définir comme une localisation de lésions localisées à la fois sur la médullaire et la corticale et qui reste stable sur le plan mécanique après mise à plat. Son traitement est difficile et demande un protocole précis. Pour cette étude, nous avons suivi les résultats de 26 patients (19 hommes et 7 femmes) dont l'âge moyen était de 34.7 ans, traités par mise à plat, irrigation, et billes de vancomycine. Dans les lésions métaphysaires, la mise à plat est réalisée à travers une fenêtre (16 patients), dans les lésions diaphysaires on réalise à la fois un alésage des lésions et une mise à plat par la fenêtre (10 patients). En addition aux billes de vancomycine, un ciment aux antibiotiques a été utilisé chez 5 patients avec lésions diaphysaires. Trois patients ont présenté une récidive secondaire à une mise à plat insuffisante. Tous ces patients ont été à nouveau traités de la même manière et avec succès. Le suivi moyen a été de 3.6 ans (2 à 6 ans) et aucun patient n'a présenté d'anomalie post-opératoire des différents paramètres clinique, radiographique et biologique. Les patients peuvent marcher et ont retrouvé leur activité d'avant le traitement. L'ostéomyé-lite chronique de type III de CM peut être traitée avec succès selon ce protocole.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Cierny-Mader Type III chronic osteomyelitis: the results of patients treated with debridement, irrigation, vancomycin beads and systemic antibiotics

Kınık

Karaduman

2007

International Orthopaedics (SICO

View full text Add to dashboard Cite

show abstract

“…23,24 Moreover, the size of the granules is also adequate to perform in vivo studies using an osteomyelitis rat model. 25 SEM images revealed the presence of interconnective macroporosity, which is desirable for bone tissue regeneration, as interconnectivity allows cell migration, neovascularization, and transport of nutrients and proteins.…”

Section: Discussionmentioning

confidence: 99%

Heparinized nanohydroxyapatite/collagen granules for controlled release of vancomycin

Coelho

Sousa

Monteiro

2015

J. Biomed. Mater. Res.

View full text Add to dashboard Cite

The purpose of this study was to develop a bone substitute material capable of preventing or treating osteomyelitis through a sustainable release of vancomycin and simultaneously inducing bone regeneration. Porous heparinized nanohydroxyapatite (nanoHA)/collagen granules were characterized using scanning electron microscopy, microcomputed tomography and attenuated total reflectance Fourier transform infrared spectroscopy. After vancomycin adsorption onto the granules, its releasing profile was studied by UV molecular absorption spectroscopy. The heparinized granules presented a more sustainable release over time, in comparison with nonheparinized nanoHA and nanoHA/collagen granules. Vancomycin was released for 360 h and proved to be bioactive until 216 h. Staphylococcus aureus adhesion was higher on granules containing collagen, guiding the bacteria to the material with antibiotic, improving their eradication. Moreover, cytotoxicity of the released vancomycin was assessed using osteoblast cultures, and after 14 days of culture in the presence of vancomycin, cells were able to remain viable, increasing their metabolic activity and colonizing the granules, as observed by scanning electron microscopy and confocal laser scanning microscopy. These findings suggest that heparinized nanoHA/collagen granules are a promising material to improve the treatment of osteomyelitis, as they are capable of releasing vancomycin, eliminating the bacteria, and presented morphological and chemical characteristics to induce bone regeneration.

show abstract

“…Auch in der Unfallchirurgie wurde eine signifikante Reduktion der Inzidenz akuter Knocheninfektionen und Osteomyelitisfälle bei offenen Brüchen mit erheblicher Schädigung des Weichteilgewebes (Gustilo-Typ-IIIB-und -IIICFrakturen) beschrieben, wenn zusätzlich zum chirurgischen Débridement und zur systemischen Antibiotikaprophylaxe antibiotikabeladene Knochenzementketten vor Ort eingesetzt wurden [34,35,53,58].…”

Section: Hintergrundunclassified

Lokale Antibiotikatherapie

2017

View full text Add to dashboard Cite

Septopal Beads and Autogenous Bone Grafting for Bone Defects in Patients With Chronic Osteomyelitis

Cited by 72 publications

References 0 publications

Cierny-Mader Type III chronic osteomyelitis: the results of patients treated with debridement, irrigation, vancomycin beads and systemic antibiotics

Cierny-Mader Type III chronic osteomyelitis: the results of patients treated with debridement, irrigation, vancomycin beads and systemic antibiotics

Heparinized nanohydroxyapatite/collagen granules for controlled release of vancomycin

Lokale Antibiotikatherapie

Contact Info

Product

Resources

About