Antibiotic/Bone-Cement Mixtures in Prevention of Infection Following Total Joint Replacement

Gardner, Alan; Medcraft, J.W.

doi:10.1016/s0140-6736(74)91217-3

Cited by 9 publications

(2 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Local antibiotic delivery systems, rather than high doses of systemic antibiotics, have been used in other surgical fields, such as orthopedic surgery, but their introduction into the plastic surgery community is recent. 31,32 Lapid 18 first introduced gentamicin-infused collagen sponges for the treatment of periprosthetic breast implant infection in a case series published in 2011. Since then, antibiotic delivery vehicles have also included absorbable antibiotic beads, continuous irrigation systems, and antibiotic-impregnated PMMA plates.…”

Section: Discussionmentioning

confidence: 99%

Use of Antibiotic-impregnated Polymethylmethacrylate (PMMA) Plates for Prevention of Periprosthetic Infection in Breast Reconstruction

Johnstone

Lipman

Makarewicz

et al. 2023

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: Periprosthetic infections remain a major challenge for breast reconstruction. Local antibiotic delivery systems, such as antibiotic beads and spacers, have been widely used within other surgical fields, but their use within plastic surgery remains scarce. In this study, we demonstrate the use of antibiotic-impregnated polymethylmethacrylate (PMMA) plates for infection prophylaxis in tissue expander (TE)-based breast reconstruction. Methods: A retrospective review of patients who underwent immediate breast reconstruction with prepectoral TEs over the span of 5 years performed by two surgeons was completed, revealing a total of 447 patients. Data pertaining to patient demographics, operative details, and postoperative outcomes were recorded. Fifty patients underwent TE reconstruction with the addition of a PMMA plate (Stryker, Kalamazoo, Michigan) impregnated with tobramycin and vancomycin. Antibiotic plates were removed at the time of TE-to-implant exchange. Patient-matching analysis was performed using the 397 patients without PMMA plates to generate a 50-patient nonintervention cohort for statistical analysis. Results: The intervention cohort (n = 50) and 1:1 patient-matched nonintervention cohort (n = 50) demonstrated no statistically significant differences in patient demographics or operative characteristics other than PMMA plate placement. The rate of operative periprosthetic infection was 4% in the intervention group and 14% in the nonintervention group (P = 0.047). The rate of TE explantation was also reduced in the intervention group (6% versus 18%; P = 0.036). Follow-up averaged 9.1 and 8.9 months for the intervention and nonintervention groups, respectively (P = 0.255). Conclusion: Local antibiotic delivery using antibiotic-impregnated PMMA plates can be safely and effectively used for infection prevention with TE-based breast reconstruction.

show abstract

Section: Discussionmentioning

confidence: 99%

Use of Antibiotic-impregnated Polymethylmethacrylate (PMMA) Plates for Prevention of Periprosthetic Infection in Breast Reconstruction

Johnstone

Lipman

Makarewicz

et al. 2023

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…47,48,51,53,54 The clinical efficacy of the technique has been demonstrated in several studies. [46][47][48]50,52,55,56 The combination of cefamandol by the venous route with a cement impregnated with vancomycin and tobramycin has been evaluated, and reduced the late prosthetic infection rate to 0%. 46 On the whole, this is an interesting method of antibiotic prophylaxis for which the indications have not been well defined, compared with the intravenous route.…”

Section: Cement Impregnated With Antibiotic In Orthopedicsmentioning

confidence: 99%

Local Antibiotic Prophylaxis in Surgery

Martin

Viviand

Potié

1996

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

The perioperative use of antibiotics is an established and accepted technique for the prevention of postoperative infection. Intravenous administration often is preferred, and intramuscular administration is possible, although it has certain drawbacks. This article examines a variety of other routes of administration for delivering antibiotics locally to the surgical site. These techniques merit further study in prospectively randomized trials.

show abstract

Effect of antibiotics on the properties of poly(methylmethacrylate)‐based bone cement

Trotignon

Loty

et al. 2002

J. Biomed. Mater. Res.

View full text Add to dashboard Cite

The goal of this study was to examine the relationship between gentamicin concentration in Palacos R bone cement (in the mass fraction range of 0-9.4%) and various properties of the cement. The results from the thermal, density, and static compression tests show that gentamicin favors the cement polymerization in its final steps, and forms a diphasic structure with the cement [poly(methylmethacrylate)] matrix. The static compression properties in the dry state are only slightly modified by the presence of the antibiotic. Concerning aging in water at 37 degrees C, two types of behavior can be distinguished: below a critical concentration, approximately 3-4%, the extraction of gentamicin by water is slow and there is only a slight change of static compression properties. In contrast, above this critical concentration, the gentamicin extraction is fast and almost complete after 48 weeks, and there is a considerable loss of static compression properties.

show abstract

Antibiotic/Bone-Cement Mixtures in Prevention of Infection Following Total Joint Replacement

Cited by 9 publications

References 2 publications

Use of Antibiotic-impregnated Polymethylmethacrylate (PMMA) Plates for Prevention of Periprosthetic Infection in Breast Reconstruction

Use of Antibiotic-impregnated Polymethylmethacrylate (PMMA) Plates for Prevention of Periprosthetic Infection in Breast Reconstruction

Local Antibiotic Prophylaxis in Surgery

Effect of antibiotics on the properties of poly(methylmethacrylate)‐based bone cement

Contact Info

Product

Resources

About