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Published on: April 22, 2016
Do Antibiotic Beads Need to be Removed?
Navin Fernando1, Shawn Werner2, Moamen Elhaddad3
1Hip and Knee Center at Northwest Primary and Specialty Care North Seattle, University of Washington, Seattle, WA, USA.
Background:
Polymethylmethacrylate antibiotic impregnated beads can be an effective treatment for chronic osteomyelitis or an adjuvant in the treatment of open fractures. It remains unclear however whether the beads cause long-term adverse events if not removed. The purpose of this study was to determine if removal of antibiotic beads was required in order to avoid long term complications.
Methods:
A retrospective chart review was conducted on patients with an extremity or pelvis fracture that had implantation of polymethylmethacrylate (PMMA) antibiotic beads over a five-year period.
Results:
Fifty-one patients met inclusion criteria for this study; thirty-seven patients (73%) did not have complications after surgical debridement and placement of PMMA antibiotic beads necessitating removal.
Conclusion:
Our findings suggest that polymethylmethacrylate antibiotic beads can be utilized as a means of delivering high-dose concentrations of local antibiotics and do not have to be removed in all patients.
Insights
Polymethylmethacrylate antibiotic beads effectively treat bone infections and open fractures. Removal is not always necessary, as most patients experience no long-term complications without bead removal.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Biomaterials Science
Background:
- Polymethylmethacrylate (PMMA) antibiotic beads are used for chronic osteomyelitis and open fractures.
- The necessity of removing these beads to prevent long-term complications is not well-established.
Purpose of the Study:
- To investigate whether antibiotic bead removal is required to avoid long-term adverse events.
Main Methods:
- Retrospective chart review of patients with extremity or pelvis fractures treated with PMMA antibiotic beads.
- Study period spanned five years.
Main Results:
- Fifty-one patients met inclusion criteria.
- A significant majority (73%) experienced no complications, even without bead removal.
Conclusions:
- PMMA antibiotic beads are effective for delivering high-dose local antibiotics.
- Routine removal of these beads may not be necessary for all patients.
