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The use of gentamicin-PMMA chains in abdominal surgery: a pilot study of prophylaxis against wound infection
Abstract:
A prospective study was carried out to examine the effectiveness of gentamicin-impregnated polymethylmethacrylate beads in the prevention of wound sepsis after gastro-intestinal surgery. The beads were laid in the abdominal and perineal incisions (61 wounds) of 55 patients at the end of the operative procedures, and were withdrawn in stages from the fifth post-operative day. This method of administration results in a sustained high antibiotic concentration in the wound with low serum and urine concentrations, thus eliminating the dangers of gentamicin toxicity. Wound infection occurred in only 1 instance, a favourable result when compared to historical controls. It is suggested that further controlled studies of this method of topical prophylactic antibiotic administration are indicated.
Insights
Gentamicin-impregnated polymethylmethacrylate beads effectively prevented wound sepsis in gastro-intestinal surgery patients. This localized antibiotic delivery method showed a low infection rate, suggesting its potential for prophylactic use.
Area of Science:
- Surgical Infection Prevention
- Pharmacology
- Biomaterials
Background:
- Wound sepsis is a significant complication following gastro-intestinal surgery.
- Systemic antibiotic administration can lead to toxicity and resistance.
- Novel localized drug delivery systems are needed to improve prophylactic efficacy.
Purpose of the Study:
- To evaluate the effectiveness of gentamicin-impregnated polymethylmethacrylate (PMMA) beads in preventing surgical site infections (SSIs) after gastro-intestinal surgery.
- To assess the safety and pharmacokinetic profile of topical gentamicin delivery via PMMA beads.
Main Methods:
- A prospective study involving 55 patients undergoing gastro-intestinal surgery.
- Gentamicin-impregnated PMMA beads were placed in abdominal and perineal incisions (61 wounds).
- Beads were removed in stages starting on postoperative day 5.
Main Results:
- Only 1 instance of wound infection was observed in the study group.
- This represents a favorable outcome compared to historical control data.
- Sustained high antibiotic concentration in the wound with low serum and urine levels was achieved, minimizing gentamicin toxicity risks.
Conclusions:
- Topical prophylactic administration of gentamicin via PMMA beads is effective in preventing wound sepsis after gastro-intestinal surgery.
- This localized delivery method offers a favorable safety profile by reducing systemic antibiotic exposure.
- Further controlled studies are warranted to confirm these findings and establish this method as a standard prophylactic approach.
