Use of biodegradable materials as local antimicrobial carriers in orthopedic infections

Abstract

INTRODUCTION: Orthopedic infections have been a major complication; despite numerous advances in prophylactic measures, infections still remain a major complication in orthopedic and trauma surgery. The progressive infection of the bone and the surrounding tissue results in bone infarcts with abscess and sequestrum formation. Adequate treatment can be an implant removal and a radical debridement with a long-term course of systemic antibiotic, but these prolonged therapies can result in side effects or toxicity. The primary reason for using local antibiotic delivery vehicles is its ability to achieve high local concentrations without associated systemic toxicity.MATERIALS AND METHODS: This is a prospective study conducted over 2 years. Thirty-five patients were studies in which 33 patients were managed with calcium sulfate + antibiotic, 1 was managed prophylactically with beads, and one was managed with Abgel + antibiotic as a biodegradable carrier. The aim was to evaluate the efficacy of biodegradable materials as antimicrobial carriers in localized orthopedic infection.OBSERVATIONS: A prospective study consists of 35 cases of orthopedic infections with major number of patients belonged to the age group of 20–40 years, with a mean 37.66 ± 19.9 years. One patient was included with soft tissue infection and rest all the patients had bone infections. It was observed that there is statistically significant improvement in ASEPSIS score at 0 week to ASEPSIS score at the end of 9 weeks.CONCLUSION: In the present study, the patients showed evidence of excellent control of infection and osseous repair, and further, none of the patients required follow-up. In our series, we have used calcium sulfate as a biodegradable antimicrobial carrier with appropriate antibiotics and achieved good-to-excellent results in local orthopedic infections.