antibiotic loaded ceramic sternum for ......antibiotic loaded ceramic sternum for sternal...
Post on 22-Oct-2020
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ANTIBIOTICLOADEDCERAMICSTERNUMFORSTERNALREPLACEMENTDURINGREFRACTORYDEEPSTERNALWOUNDINFECTION
JérémyTRICARD,AnaëlleCHERMAT,EricDENES,SouleimanELBALKHI,FrançoisBERTIN
ThoracicandCardiovascularSurgerydepartmentLIMOGESUniversityHospital,France
Objective:Sternumreconstructionafteritsdestructionduringrefractorydeepsternalwoundinfection(DSWI)mainlyreliesonvacuum-assistedclosuretherapy(VAC)andmuscleflapswhichhassome pitfalls. We report here the use of an antibiotic loaded prosthesis for sternalreplacementduringDSWI(CERAMIL®).Thedeviceisaporousaluminasternumloadedwithgentamicin.Theaimistoobtainamechanicalreplacementofthesternumassociatedtoitsbacterialprotectionduringimplantationthankstoantibioticlocalrelease.
Table2:Localgentamicinconcentrationexceededtheoneneededforitsefficacywhilenoantibioticwasfoundintheblood
Conclusions:ThesethreeimplantationsarepromisingforpatientswithsternaldestructionafterDSWI,offeringaprotectionagainstbacteria.
Methods:ThisdevicewasimplantedinthreemalepatientswithDSWIandpersistentinfectedsternaldehiscencefollowingcoronaryheartby-pass.
H1 H24 FromH1toH48Antibiotic Loaded
dose(mg)
Localconcentration(mg/L)
Comparisontotheneededconcentration
Localconcentration(mg/L)
Comparisontotheneededconcentration
Antibioticsampledinblood(mg/L)
#2 Gentamicin 320 1500 >175folds 395 >50folds 260folds 37 >5folds
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