title: [Augmentation with antibiotic-impregnated spacers in sepsis revision surgery].
abstract: BACKGROUND
  The development of antibiotic-impregnated polymethyl methacrylate (PMMA) spacers is based on clinical experience and the use of antibiotic-loaded PMMA beads in septic bone surgery as well as antibiotic-loaded bone cement in arthroplasty beginning in the 1970s.
  
  
  METHODS
  In the meantime hand-formed and prefabricated spacers are implanted in cases of sepsis to achieve high local antibiotic concentrations and bactericidal effects to eradicate the infection. Preformed spacers with gentamicin are commercially available and furthermore, clindamycin-loaded PMMA bone cement can also be used. In principle, all thermostable antibiotics can be mixed with PMMA cement.
  
  
  CONCLUSIONS
  Spacers permit bridging of bone defects originating from trauma or septic bone segment resection. After joint resection spacers allow a certain degree of articulation and inhibit shortening of the extremity which has a positive effect on the soft tissue covering and its perfusion.
  
  
  CONCLUSIONS
  The functional outcome after secondary arthroplasty is better if a spacer has been implanted compared to long-term immobilization without spacers. Nevertheless, spacers can also cause serious complications, such as dislocations and fractures. Antibiotic-loaded spacers have therefore widened the therapeutic options in sepsis surgery.
authors.affiliation: Sektion Septische Chirurgie, BG Unfallklinik Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Deutschland. iflesch@bgu-tuebingen.de.
authors.forename: I
authors.initials: I
authors.lastname: Flesch
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001843:Bone Cements / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004343:Drug Implants / Q000008:administration & dosage*; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D058498:Kyphoplasty / Q000379:methods*; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D018805:Sepsis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D004343:Drug Implants
keywords: Antibiotics; Complications; Indications; PMMA; Spacers