Antibiotic Impregnated Beads, Indications in musculoskeletal infection

The management of musculoskeletal infection as a result of acute extremity injury remains a challenge to the experienced surgeon. The current treatment of acute debridement and wound irrigation remain the most important factors in the prevention of acute or chronic infection. Skeletal stabilisation and appropriate soft tissue coverage are also imperative in the standard care of these complicated traumatic wounds. Once stabilised, severe open fractures remain at risk as a result of the compromised vascularity of the bone and soft tissue. Parenteral broad-spectrum antibiotics are recommended as a prophylaxis to the open wound contamination. In such injuries the therapeutic levels of the antibiotics are frequently diminished by the impaired tissue perfusion, vasospasm, edema and vascular damage.