Application of gentamicin-collagen sponge shortened wound healing time after minor amputations in diabetic patients - a prospective, randomised trial.

Abstract

IntroductionDiabetic foot infections are frequently polymicrobial. The lower tissue concentration of systemically administered antibiotics in diabetic patients was reported. Collatamp®EG (Syntacoll GmbH Saal/Donau, Germany) is a bioabsorbable, gentamicin impregnated collagen spongeused for local treatment. The aim of this randomized trial was to assess influence of gentamicin-collagen sponge applied to a wound on surgical outcomes after minor amputations in diabetic patients.Material and methodsFifty diabetic patients indicated for minor amputation in 2009 at our surgery department were included in the study. Patients were pre-operatively randomised into two groups. Twenty-five patients in group A were treated with gentamicin impregnated collagen sponge applied into wound peri-operatively while 25 patients in group B had minor amputation without gentamicin sponge.ResultsThere was no significant difference in the demographic data, procedures performed, diabetes duration and peripheral vascular disease severity between the groups. The median glycosylated haemoglobin was 6.0% (range: 4.6–9.5%) in group A and 6.2% (range: 4.0–8.4%) in control group B (non-significant). Median TcPO2 level was 44 (range: 13–67) in group A and 48 (range: 11–69) in control group B (non-significant). The median of wound healing duration in group A was 3.0 weeks (range: 1.7–17.1 weeks) compared to 4.9 weeks (range: 2.6–20.0 weeks) in control group B. This was with a statistically significant difference (p < 0.05).ConclusionsApplication of gentamicin impregnated collagen sponge shortened wound healing duration after minor amputations in diabetic patients by almost 2 weeks.