The Potential of Antibiotic Collagen Based Biocomposites for the Treatment of Bone Defects

Abstract

Antibiotic delivery systems used in the past have consisted primarily of impregnated cement beads that required routine removal once the antibiotic had eluded completely. With the development of collagen scaffolds that could be used to fill bony defects the antibiotic cold be delivered from the scaffold used to sustain local bone growth. Over the course of two years antibiotic loaded collagen scaffolds were used in the local treatment of 21patients suffering of complicated fractures including bone defects, infections or pseudoarthrosis, all of them of traumatic nature. At the time of the initial surgical debridement or at subsequent second look procedures once local tissue viability was observed the antibiotic loaded collagen scaffold was inserted in the tissue defect and never removed. Excellent results were obtained and the infection was brought under control by use of both surgical and antibiotic modalities. Bone grafting was used in 6 cases where the defects were extensive. Where there was less extensive bone destruction the scaffold was a good adjuvant in new bone formation. Use of antibiotic loaded collagen scaffolds is a reliable and effective means of local antibiotic delivery system combining both the new bone formation capacity of the scaffold to hold osteoblasts with the ability to deliver high doses of antibiotic in the local tissue environment and thus avoiding the systemic toxicity.