The application of 2 to 5 130-mg gentamycin-loaded collagen fleeces may be useful as an adjuvant treatment for implant-related infections, since no toxic concentrations were measured 24 hours postoperatively.
Patients and methods All 12 patients treated during 1997-2001 were included. 4-6 sponges were used in each case. We measured the serum gentamicin levels daily, from the first postoperative day until gentamicin was no longer measurable. The creatinine levels were monitored daily and the creatinine clearance was calculated according the Cockcroft-Gault formula.Results In 7 of the 12 patients, we found toxic serum levels of gentamicin (range 2-13 mg/L). In 3 cases there was a significant drop in renal clearance, which persisted. In 3 other cases there was a temporary decrease in renal clearance.Interpretation We found toxic serum levels after local administration of gentamicin. We even found a persistent decrease in renal clearance in some patients. Because of the alarming results, we have reduced the number of sponges used for this purpose.
At an average follow-up of 8 years, this proximally HA-coated femoral component showed favorable clinical and radiological outcome and excellent survivorship.
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