Abstract
For the treatment of infected joints, bones and soft tissues, either an instillation drainage therapy or the use of gentamicin-polymethyl-methacrylate (PMMA) chains (Septopal) in addition to surgical revision and systemically given antibiotics is currently in clinical use. We investigated 102 patients treated in our clinic by means of instillation drainage and compared the results with those obtained with gentamicin-PMMA chains by other authors. The overall long-term success with non-recurrence of the infection is nearly comparable (80% instillation drainage, 84% gentamicin-PMMA chains); however, with instillation drainage the duration of hospitalisation is significantly longer (mean 42.26 days vs 15.3 – 33 days). Additionally, there was a high rate of germ shifts with instillation drainage (33.3%) and a disappointing result in 20 infected endoprostheses (9 recurrences with 11 revisions). Regarding the intensive nursing care required and the necessary isolation from other patients, instillation drainage can only be recommended for the therapy of infected joints, bones and soft tissues if the results are better in comparison with gentamicin-PMMA chains. An improvement may be achieved with the closed instillation drainage system.
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References
Asche G (1978) Spülsaugdrainage oder Gentamycin-PMMA-Kugeln in der Therapie infizierter Osteosynthesen. Unfallheilkunde 81:463–468
Blaha JD, Nelson CL, Frevert LF, Henry SL, Seligson D, Esterchai JL, Heppenstal RB, Calhoun J, Cobos J, Mader J (1990) The use of Septopal (polymethylmethacrylate beads with gentamicin) in the treatment of chronic osteomyelitis. Instr Course Lect 39:509–514
Dingeldein E (1983) Bakteriologische Untersuchungen bei Patienten unter der Behandlung mit Gentamicin-PMMA-Ketten. Polim Med 13:9–10
Grieben A (1983) Klinische Ergebnisse mit Septopal-Kette in Knochen- und Weichteil-Indikation. Polim Med 13:29–30
Harms V (1988) Biomathematik, Statistik und Dokumentation. Harms, Kiel
Hendrich V, Kuner EH (1986) Die Saug-Spül-Behandlung bei der Behandlung der chronischen Osteomyelitis. Unfallchirurgie 12:101–103
Höök M, Lindberg L (1987) Treatment of chronic osteomyelitis with gentamicin-PMMA beads. Trop Doct 17:157–163
Jenny G (1988) Local antibiotic therapy using gentamicin-PMMA chains in post-traumatic bone infections, short and long-term-results. Reconstr Surg Traumatol 20:36–46
Klemm K (1979) Gentamycin-PMMA-Kugeln in der Behandlung abszedierender Knochen- und Weichteilinfektionen. Zentralbl Chir 104:934–942
Lütje HC, Penschuck C, Aydin V (1988) Local antibiotic treatment of soft-tissue infections with gentamicin-PMMA chains. Reconstr Surg Traumatol 20:112–119
Pfister A, Ochsner PE (1993) Erfahrungen mit geschlossenen Spül-Saug-Drainagen und gleichzeitiger Anwendung eines Antiseptikums. Unfallchirurg 96:332–340
Quell M, Vécsei V (1986) Mittelfristige Ergebnisse über die Behandlung der posttraumatischen Osteitis und Osteomyelitis mit Gentamicin-PMMA-Miniketten. Aktuel Traumatol 16:158–160
Sachs L (1984) Angewandte Statistik. Springer, Berlin Heidelberg New York
Schuckmann P, Schuckmann W (1989) Unsere Erfahrungen mit dem Einsatz von Septopalketten bei der Behandlung baktrieller Arthritiden und Osteomyelitiden. Beitr Orthop Traumatol 36:428–434
Schumpelick V, Bleese NM, Mommsen U (1989) Chirurgie. Enke, Stuttgart
Weise K, Müller HP (1988) Die lokale Antibiotikatherapie bei postoperativer und posttraumatischer Osteitis mit der Septopal®-Kette. Unfallchirurg 91:416–421
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Schmidt, J., Hackenbroch, M.H., Kumm, D. et al. Is instillation drainage for the treatment of infected joints, bones and soft tissues still up to date?. Arch Orthop Trauma Surg 115, 149–152 (1996). https://doi.org/10.1007/BF00434543
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DOI: https://doi.org/10.1007/BF00434543