Local application of gentamicin-containing collagen implant in the prophylaxis and treatment of surgical site infection in orthopaedic surgery.
BACKGROUND
There is still significant risk of patients developing surgical site infection (SSI) following orthopaedic surgery due to growing demand for joint surgery in high-risk patients and increasing complexity of procedures. The higher rate of SSI seen in high-risk procedures and also in high-risk patients is of concern as the development of infection can be a very serious complication of orthopaedic surgery and has implications for patient morbidity, length of hospital stay (LOS), resource utilisation and healthcare costs. This article provides an overview of the efficacy of prophylactic and therapeutic application of resorbable gentamicin-containing collagen implants (GCCI) in the prevention of SSI following orthopaedic surgical procedures.


METHODS
Thirteen publications were identified using the PubMed online database and search terms 'gentamicin-containing collagen implant' plus 'orthopaedic surgery', 'osteomyelitis', 'osteitis', 'amputation', 'surgical site infection' and 'wound infection'.


RESULTS
Five studies have demonstrated that prophylactic use of GCCI can reduce the wound infection rate in orthopaedic surgical procedures ranging from discectomy to amputation in patients with diabetes. Eight studies have demonstrated that GCCI may also have a role to play in treating both acute and chronic osteomyelitis.


CONCLUSIONS
This review demonstrates that prophylactic use of GCCI can have a positive effect on wound healing in a range of orthopaedic surgical procedures and in high-risk patients. GCCI may also have a role to play in the treatment of osteomyelitis.
Department of Trauma and Orthopaedic Surgery, Lahn-Dill-Kliniken GmbH, 35578 Wetzlar, Germany. Harald.Knaepler@Lahn-Dill-Kliniken.de
Harald
H
Knaepler
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D024042:Collagen Type I / Q000008:administration & dosage*; D004343:Drug Implants; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods*; D010019:Osteomyelitis / Q000188:drug therapy / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*
D000900:Anti-Bacterial Agents; D024042:Collagen Type I; D004343:Drug Implants; D005839:Gentamicins