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Local Antibiotic Delivery Systems and Rates of Post-Operative Complications: Calcium Sulfate Beads Versus Chitosan Sponges.
Joseph Easton MD, Ivan Hadad MD
University of Cincinnati
2021-01-11
Presenter: Joseph Easton
Affidavit:
This project represents the original work of the resident.
Director Name: Ann Schwentker MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Objectives: To determine if there is a difference in rates of wound dehiscence, fracture delayed union, nonunion, and unanticipated surgery after the use of bioabsorbable local antibiotic delivery systems (LADS), specifically comparing antibiotic impregnated calcium sulfate pellets (Osteoset-T, Wright Medical Technology Inc., Arlington, TN) and chitosan sponge (Sentrex BioSponge, Bionova Medical, Germantown, TN) in the management of acute and chronic extremity wounds.
Design: Retrospective comparative cohort.
Setting: Level 1 trauma center.
Patients/Participants: All patients who received either antibiotic impregnated calcium sulfate beads or chitosan sponge as an adjunct to surgical debridement from January 2010-December 2017 were included, and 136 of these met the inclusion criteria.
Intervention: Extremity wounds were treated with bioabsorbable local antibiotic-delivery systems, either calcium sulfate beads or chitosan sponge. Main Outcome Measurement: Wound dehiscence and need for unanticipated surgery. Results: Of the 136 patients in the study cohort, 77.9% were treated with Osteoset calcium sulfate beads and 22% with Sentrex chitosan sponges. When comparing groups, 67.4% of patients requiring unanticipated surgery (p=0.025) and 62.0% of patients with wound dehiscence (p=0.0001) were seen in the calcium sulfate bead group. However, in multivariable analyses, we found that the odds of having wound dehiscence and undergoing unanticipated surgery were, respectively, 4.9 (p=0.001) and 2.8 (p=0.021) times more likely to occur in chitosan sponge than in calcium sulfate bead groups.
Conclusion: Chitosan sponge appears to be associated with higher rates of wound dehiscence and need for unanticipated surgery compared to calcium sulfate beads.
