Treatment of chronic osteomyelitis by antibiotic-polymethylmethacrylate beads.

概要

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Treatment of chronic osteomyelitis by antibiotic-Polymethylmethacrylate beads has following advantages; (1) very high local cencentration of antibiotics is achieved without systemic toxic side effect; (2) the patient is not restricted to bed and thus comfortable; (3) there is less responsbility for the physician and nursing staff because the patient does not require continuous control; (4) there is no effects on bone mechanism.Our procedure is as follows. Following complete necrectomy, we implant self-made antibiotic-polymethylmethacrylate beads containing two or three species of antibiotics which are chosen among aminoglycosides, cephems and penicillins. As there is an extensive bone defect, a reoperation is performed several weeks after surgery to remove beads and to fill the cavity with cancellous bone graft. When bone itself is unstable, internal fixation is added.Six cases of chronic Osteomyelitis were treated by this method. Follow-up from five to twenty months arter bone graft, revealed that five stayed free of relapse after initial course of treatment. The remaining patient was not completely free of infection.
西日本整形・災害外科学会の論文