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Published on: March 14, 2019
Continuous Local Antibiotic Perfusion for Refractory Musculoskeletal Infections: Functional and Patient-reported
Shingo Kurahashi1,2, Mari Yamamoto1,3, Norio Yamamoto2,4
1Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, 455-8530, Japan.
Journal of Orthopaedic Case Reports
|July 10, 2026
Summary
Continuous local antibiotic perfusion (CLAP) effectively treats bone and soft-tissue infections, achieving high clearance rates and patient satisfaction. This method offers a viable adjunctive treatment for challenging musculoskeletal infections.
Area of Science:
- Orthopedics
- Infectious Diseases
- Surgical Innovation
Background:
- Continuous local antibiotic perfusion (CLAP) is a novel treatment for bone and soft-tissue infections, maintaining high local antimicrobial concentrations and minimizing systemic toxicity.
- Despite its effectiveness, clinical indications, protocols, and patient-reported outcomes for CLAP remain unclear.
Purpose of the Study:
- To assess the clinical outcomes and patient satisfaction following CLAP for musculoskeletal infections of varied etiologies and anatomical sites.
Main Methods:
- A retrospective series of 13 patients undergoing CLAP (gentamicin infusion with negative-pressure wound therapy) for musculoskeletal infections between January 2020 and March 2025.
- Outcomes included infection resolution, additional surgical procedures, length of hospital stay, functional recovery, and patient satisfaction (Likert scale, NPS).
Main Results:
- High infection clearance rate (92%) within a median of 37 days.
- Favorable functional recovery (69.3%) and high patient satisfaction (84.6% would undergo again, mean NPS 8.2).
- A median of four additional procedures were required, with 46.2% of patients needing implant removal.
Conclusions:
- CLAP achieved high infection clearance rates and favorable functional and satisfaction outcomes.
- CLAP is a feasible adjunctive option for refractory musculoskeletal infections within comprehensive management strategies.
