[Use of mini-septopal in trauma surgery of the hand. Experimental and clinical studies]

The antibiotics application in treatment of infections makes necessary that they are present in the focus of infection in concentration which is enough to fight back bacteria responsible for the symptoms of disease. Concentration higher then MIC is especially difficult to obtain in tissue with poor blood supply.c. in the cortical bone. Many attempts has been made to find proper method to obtain high antibiotic concentration in the infection focus without overloading the rest of the organism. In the years 1972-1973 Klemm in Frankfurt/Main had first very promising results treating bone infections by filling bone cavities after proper surgical debridement with hand-made beads made of bone cement with gentamicin. This method has been developed by the E. MERCK company which started to produce drug as Septopal. Very good results of treatment using this form of antibiotic created natural demand for this method also in hand surgery, where big sized Septopal beads couldn't be used. E. MERCK company has provided us with Septopal Mini Chains where small ellipsoids are gathered in 10- or 20 elements chains. Starting investigations on SMC application the following aims of experimental and clinical studies has been pointed out: observation of tissue reaction for the implanted ellipsoids, studies on gentamicin releasing velocity and its concentration in the implantation site as well as in the tissues of peripheral organs, observation of the potential toxicity and observation of the ellipsoids structure in the scanning electron microscopy, evaluation of usefulness of the SMC in the treatment of bone and soft tissue infections and in prophylactics in high risk wounds treatment, evaluation of its efficiency in comparison with gentamicin-resisted bacterial strains. Statistical analysis of results has proved very high efficiency of this form of drug by obtaining very high local antibiotic concentration even 100 times higher then after parenteral application. No toxic reactions has been noticed. In the Department of Traumatology Medical Academy in Wrocław in the years 1983-1991 Septopal Mini Chains has been applied in 76 cases and very good results-complete healing has been obtained in 83% of patients. These data allow us to evaluate very high the usefulness of the Septopal Mini Chains as very good, new method of bone and soft tissue infection treatment in the area of hand.