Use of gentamicin in the treatment of access-port infections.
BACKGROUND
A therapy concept for access-port infections is presented.


METHODS
Between January 2001 and May 2005, 556 adjustable gastric bands were placed laparoscopically, and access-port infection data were analyzed. 6 early infections and 1 late infection occurred. 2 early infections were treated successfully with placement of a PMMA-chain at the port-site--without port removal. 2 other early infections were treated successfully with port removal and later reconnection; however, infection recurred at the access-port soon after reconnection, so a PMMA-chain was positioned around the port. The last 2 early infections were treated successfully by port removal and later connection of a new access-port surrounded by a PMMA-chain. The late access-port infection appeared to be caused by gastric erosion.


RESULTS
Complete healing was achieved in all cases of early infection, and follow-up revealed no complications with subsequent band adjustments. The gastric erosion required removal of the entire banding system.


CONCLUSIONS
For early port infection, the placement of a PMMA-chain around the subcutaneous port appears to be a safe and effective approach that is less invasive than the usual port removal under general anesthesia. Placing the PMMA-chain is a rapid and simple procedure that allows retention of the original access-port. Once local healing is complete, the port can then be accessed easily and safely for band inflation.
Speybrouck
S
S
Department of Surgery, Imeldahospital, Bonheiden, Antwerp, Belgium. sspeybrouck@tiscali.be
Aelvoet
C
C
Tollens
T
T
Vanrykel
J P
JP
D034861:Abdominal Wall; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D015391:Gastroplasty / Q000295:instrumentation*; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008768:Methylmethacrylates / Q000008:administration & dosage; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011677:Punctures; D013530:Surgical Wound Infection / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D008768:Methylmethacrylates; C030159:gentamicin-polymethylmethacrylate bead