Naslov
Chronic osteomyelitis-role of bone void fillers in surgical treatment

Autori
Mađarević, Tomislav ; Vučković, Darinka ; Širola, Luka ; Lopac, Danijel ; Rakovac, Ivan ; Tudor, Anton

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Abstract Book / - Trakošćan, 2018

Skup
Kongres Hrvatskog udruženja ortopeda i traumatologa (HUOT 2018)

Mjesto i datum
Trakošćan, Hrvatska, 12.04.2018. - 14.04.2018

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Domaća recenzija

Ključne riječi
osteomyelitis ; fillers ; treatment

Sažetak
Introduction: Chronic osteomyelitis is an chronic infection of bone and bone marrow. It may present with periods of quiescence of variable duration, whereas its occurrence, type, severity and prognosis is multifactorial. A combined antimicrobial and surgical treatment should be considered in all cases, including appropriate dead space management and subsequent reconstruction. Chronic osteomyelits may recur if dead space management, after excision of dead bone, is inadequate which has a major impact on the quality of life of patients and is a substantial financial burden to any healthcare system. Material and methods: In the period 2016-2017 altogether 32 patients were treated due to chronic osteomyelitis. Pateients were assigned into 3 groups according to the surgical method which was used. Three methods of surgical treatments were: 1. radical surgical debridement without dead space management ; 2. two stage treatment which included radical surgical debridement with dead space management done with antibiotic cement (spacer) during the first stage and extraction of spacer and filling of bone void with autologus bone graft during the second stage (Masquelet technique) and 3. one stage radical surgical debridement with dead space managment done with absorbabale, gentamicin or vancomycin loaded, calcium sulphate/hydroxyapatite biocomposite ( ™ CERAMENT G or ™ CERAMENT V). There were 14 pateints in group 1, 7 pateints in group 2 and 11 pateints in group 3. Results: Patients were followed up at least for six months (6 - 24 months). In the group 1 there were 9 reccurences (64%), in the group 2 there was 1 reccurence (14%) and in the group 3 there were 2 reccurneces (18%). Outcome was not dependant on Cierny-Mader host class. Conclusion: Dead space management with local application of antibiotics is vital in the treatment of chronic osteomyelitis. Preliminary results are comparable for group 2 and group 3 but in the group 2 there is a two stage treatments which require also autologous bone graft which can cause donor site morbidity. One stage procedure with antibiotic loaded bone void filler could improve infection control and it offers a more patient-friendly treatment. We can not recommend surgical treatment without adequate dead space management because of high reccurence rate.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA