Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Infections
Abstract number: 23988
VACUUM ASSISTED DRESSING AND CULTURE SPECIFIC ANTIBIOTIC BEADS
FOR CONTROL OF IMPLANT INFECTION
Rajeshkumar KAKWANI, Kailash DEVALIA, A. MURTY
Wansbeck Hospital, Newcastle Upon Tyne (UNITED KINGDOM)
Aim: The control of infection around internal fixation devices is generally difficult due
to the formation of glycocalyx around the metallic implants. Early infections are
generally dealt with by washout and parenteral antibiotics. We present our series of
successful control of acute infection around internal fixation devices with the use of
culture specific high dose antibiotic cement beads and negative pressure dressings.
Methods and Materials: Prospective collection of data of 12 consecutive patients who
underwent debridement with antibiotic bead insertion and VAC dressing for acute
infection around internal fixation devices were included in the study. All operations
were performed or closely supervised by a single surgeon. Patients were followed
up prospectively for minimum of 6 months following the index procedure. Secondary
outcome measures included complications such as repeat debridement, delayed
wound healing & removal of internal fixation device. Results: There were 6 females
and 6 males. The average age was 54 years (Range 26 to 82). The follow up period
was between 6 to 24 months. All patients underwent successful wound healing and
union around the fracture / arthrodesis site. One patient needed removal of plates
following the fracture union for residual pain. Discussion: Custom made culture
specific antibiotic beads facilitate the local delivery of high doses of specific
antibiotics without any systemic side-effects. The use of vacuum assisted dressing
helps reduction of collection around the internal fixation device and accelerates
wound healing, allowing retention of the internal fixation devices till fracture /
arthrodesis union.
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