[Use of Septopal in the treatment of bone infections]

The authors evaluate a group of 29 patients where they used during treatment of a bone infection gentamicin pellets--Septopal Merck. The mean age of the patients was 46.6 years (9-75 years) the mean duration of the symptoms of inflammation before operation was 20 months. The prerequisite of successful application of Septopal is radical surgical treatment of the site of infection and provision of high standard soft tissue covering and assessment of the sensitivity of the aetiological agent to gentamicin. The most frequent causal agent of infection was Staphylococcus aureus in 48.3% and in combination with Gram-negative rods in 34.5%. In infections of total prostheses of joints one of the pathogenic agents was also Staphylococcus epidermidis. Healing per primam was recorded in 41% per secundam in 28%, in general, treatment was successful in 69%. By application of Septopal high local bactericide concentrations of gentamicin can be achieved for three months without threatening the patient with toxic side effects--local or general. The authors recommend, however, to remove it after cca 8 weeks.