Abstract：
OBJECTIVE: The optimal means of local antibiotic delivery for fracture related infection is unknown. Until now, intramedullary application of calcium sulphate based local antibiotics has been challenging. We report on the use of a newly available mode of preparation and delivery: the Stimulan Bullet Mat and Introducer (Biocomposites Ltd, Staffordshire, England).
METHODS: A retrospective analysis of prospectively collected data for infection cases at two separate tertiary referral institutions was performed. We included cases of long bone FRI with a retained intramedullary nail, treated with a single stage protocol of metalwork removal, debridement, local antibiotic application using the novel mould and applicator, with additional bony stabilisation and soft tissue reconstruction where required.
RESULTS: All 13 patients achieved infection remission rate with an average follow-up of 19.7 months (range 12-28). All 6 patients with infection around an unhealed fracture achieved union at an average 8 months (range 4-12) from debridement. No patients developed aseptic wound leak.
CONCLUSIONS: Antibiotic impregnated calcium sulphate can be used safely as part of a single stage treatment protocol for the treatment of long bone fracture related infection following intramedullary nailing. We have demonstrated high rates of infection remission and union, using a newly available intramedullary applicator.
METHODS: A retrospective analysis of prospectively collected data for infection cases at two separate tertiary referral institutions was performed. We included cases of long bone FRI with a retained intramedullary nail, treated with a single stage protocol of metalwork removal, debridement, local antibiotic application using the novel mould and applicator, with additional bony stabilisation and soft tissue reconstruction where required.
RESULTS: All 13 patients achieved infection remission rate with an average follow-up of 19.7 months (range 12-28). All 6 patients with infection around an unhealed fracture achieved union at an average 8 months (range 4-12) from debridement. No patients developed aseptic wound leak.
CONCLUSIONS: Antibiotic impregnated calcium sulphate can be used safely as part of a single stage treatment protocol for the treatment of long bone fracture related infection following intramedullary nailing. We have demonstrated high rates of infection remission and union, using a newly available intramedullary applicator.
摘要：
目的：骨折相关感染的局部抗生素给药的最佳方法未知。直到现在,基于硫酸钙的局部抗生素的髓内应用一直具有挑战性。Wereportontheuseofanewavailablemodeofpreparationanddelivery:theStimulanBulletMatandIntroducer(BiocompositiesLtd,斯塔福德郡,英格兰）。
方法：对两个独立的三级转诊机构的感染病例的前瞻性收集数据进行回顾性分析。我们纳入了保留髓内钉的长骨FRI病例，用金属制品去除的单阶段方案处理，清创术,使用新型模具和涂药器的局部抗生素应用，额外的骨稳定和软组织重建在需要的地方。
结果：所有13例患者均达到感染缓解率，平均随访时间为19.7个月（范围12-28）。所有6例未愈合的骨折周围感染的患者在清创后平均8个月（范围4-12）均实现了愈合。无患者出现无菌伤口渗漏。
结论：抗生素浸渍硫酸钙可以安全地用作单阶段治疗方案的一部分，用于治疗髓内钉术后长骨骨折相关感染。我们已经证明感染缓解和愈合率高，使用新的髓内涂药器。
方法：对两个独立的三级转诊机构的感染病例的前瞻性收集数据进行回顾性分析。
结果：所有13例患者均达到感染缓解率，平均随访时间为19.7个月（范围12-28）。
结论：抗生素浸渍硫酸钙可以安全地用作单阶段治疗方案的一部分，用于治疗髓内钉术后长骨骨折相关感染。
