- 期刊
以gentamicin骨泥珠鏈局部治療慢性骨髓炎
Gentamicin-Pmma-Chains (Septopal Chains) for the Local Antibiotic Treatment
摘要
慢性骨髓炎病人，實施抗生素治療之前，必須先作外科手術，切除死骨，拔除內固定器材。外科清創術後，在感染部位植入「gentamicin 骨泥珠鏈」，可以獲得極高的局部抗生素濃度。這種局部抗生素濃度，不僅遠超過同類抗生素的全身性抗生素療法，並且遠超過常見的致病細菌的萬低抑菌濃度(MIC)和最低殺面濃度(MBC)。其手術後傷口癒合的情況，可以比美一般的每菌手術。病人可以早期離床活動和出院。治療過程比「開放式傷口療法」或「連續灌洗一吸引式引流法」更令病人愉快。通常不必附加全身抗性生素注射。 我們在法蘭克福B. G. Trauma clinic 的病人治療的結果是：405例暫時植入珠鏈的病例，經6~78個月追蹤報告，復發率是9.6%；45例永久植入珠鏈的病例，復發率是13%。
並列摘要
In cases of chronic osteomyelitis, surgical intervention with the removal of sequestra and alloplastic implants is an indispendable precondition for any antibiotic therapy, which can only be a complementary measure. The temporary or permanent implantation of gentamicin-PMMA chains in infected bone cavities following surgical debridement, achieves local concentrations of gentamicin which are far higher than those following systemic administration of the same antibiotic. These local concentrations are also distinctly higher than the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the aetiologically most important pathogens. Furthermore the course of postoperative healing is equivalent to that in asepic operations and enbles the patient to be mobilized and discharged at an early stage. The course of treatment is also significantly more pleasant for the patient than that in open wound treatment or when irrigation-suction drainage is used. In our own patient population the incidence of recurrence was 9.6% in 405 cases of temporary implantation and 13.0% in 46 cases of permanent implantation of gentamicin-PMMA chains in chronic osteomyelitis.