title: Application of gentamicin-collagen sponge shortened wound healing time after minor amputations in diabetic patients - a prospective, randomised trial.
abstract: BACKGROUND
  Diabetic foot infections are frequently polymicrobial. The lower tissue concentration of systemically administered antibiotics in diabetic patients was reported. Collatamp(®)EG (Syntacoll GmbH Saal/Donau, Germany) is a bioabsorbable, gentamicin impregnated collagen spongeused for local treatment. The aim of this randomized trial was to assess influence of gentamicin-collagen sponge applied to a wound on surgical outcomes after minor amputations in diabetic patients.
  
  
  METHODS
  Fifty diabetic patients indicated for minor amputation in 2009 at our surgery department were included in the study. Patients were pre-operatively randomised into two groups. Twenty-five patients in group A were treated with gentamicin impregnated collagen sponge applied into wound peri-operatively while 25 patients in group B had minor amputation without gentamicin sponge.
  
  
  RESULTS
  There was no significant difference in the demographic data, procedures performed, diabetes duration and peripheral vascular disease severity between the groups. The median glycosylated haemoglobin was 6.0% (range: 4.6-9.5%) in group A and 6.2% (range: 4.0-8.4%) in control group B (non-significant). Median TcPO2 level was 44 (range: 13-67) in group A and 48 (range: 11-69) in control group B (non-significant). The median of wound healing duration in group A was 3.0 weeks (range: 1.7-17.1 weeks) compared to 4.9 weeks (range: 2.6-20.0 weeks) in control group B. This was with a statistically significant difference (p < 0.05).
  
  
  CONCLUSIONS
  Application of gentamicin impregnated collagen sponge shortened wound healing duration after minor amputations in diabetic patients by almost 2 weeks.
authors.affiliation: Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Varga
authors.affiliation: Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Bedrich
authors.initials: B
authors.lastname: Sixta
authors.affiliation: Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Robert
authors.initials: R
authors.lastname: Bem
authors.affiliation: Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University of Leipzig, Leipzig, Germany.
authors.forename: Ivan
authors.initials: I
authors.lastname: Matia
authors.affiliation: Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Jirkovska
authors.affiliation: Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Milos
authors.initials: M
authors.lastname: Adamec
keywords: amputation; diabetic foot; gentamicin; wound healing