Use of gentamicin-loaded collagen sponge in internal fixation of open fractures[1].pdfVIP免费

ChineseJournalofTraurnatology2011；14(41：209—214209Useofgentamicin—-loadedcollagenspongeininternal一●_一tIxationotopenfracturesChaudharySusheel,SenRamesh，SainiUttamChand，SoniAshwani,GahlotNiteshandSinghDaljit[Abstract]Objective：Toassesstheoutcomeofimmediateplateosteosynthesisviaapplicationofantibioticimpregnatedcollagenfleeces(gentamicin—collagenandan—tibioticsponge)whichgraduallyreleaseantibioticlocallyinthesurgicaltreatmentofopenfracturespresentedtous6hoursafterinjury．Methods：AUcasesweretreatedinourtertiaryleveltraumacenterandteachinghospitalincluding35patientswithopenfractureswhoweretreatedbyimmediateopenreductionandplatefixationfromJanuary2008toAugust2010．Amongthem，3lpatientswereavailableforadequatefollow．upandassessment．Allfracturesweretreatedbyirri—gationanddebridement，immediateopenreductionandplatefixationalongwithplacementofantibiotic—releasingcollagenfleecesaroundtheplateiustbeforeclosureofwound．Pa-tientswereassessedtodeterminepostoperativeinfection，delayedunionornonunionanddevelopmentofotherpost—operativecomplications．Itwashypothesizedthatimmedi‘ateplateosteosynthesisafterthoroughdebridementandlocalantibioticswouldgivesafeandacceptableclinicalre·suitsintreatmentofopenfractures．ResnIts：The31patientswithadequatefinalfollow—upwereassessedatameantimeof40weeksr15-160weeks)．Openfracturesarealwaysthoughttobeasso-ciatedwithanincreasedriskofinfectionandhealingcomplications．IncidencesofinfectionfollowingelectiveorthopedicsurgeryarelowandrangefrOmO．7％一4．2％．1,2Thisdependsuponthetypeofsurgery，softtissuestatus，generalpatientcondition，andperioperativeuseofprophylacticantibiotics．0Pa—tientswithopenfracturesclearlyshowahigherriskofinfectionf5％一33％4，duetobacteriaIcontaminationandDOI：1O．3760／cma．j．issn．1008—1275．2011．04．003DepartmentofOrthopedics，PostGraduateInstituteofMedicalEducationandResearch，Chandigarh160012，India(ChaudharyS，SenRK，SainiUC，SoniA，GahlotNandSinghD)COrrespOndingauthor：Tel：91-9855004450，Emado...