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Do antibiotic impregnated calcium sulphate beads improve the healing of neuropathic foot ulcers with osteomyelitis undergoing surgical debridement?

Dekker, Andrew; Uzoho, Chukwudi; Scammell, Brigitte

Do antibiotic impregnated calcium sulphate beads improve the healing of neuropathic foot ulcers with osteomyelitis undergoing surgical debridement? Thumbnail


Authors

Andrew Dekker

Chukwudi Uzoho

Brigitte Scammell



Abstract

Background: Neuropathic foot ulcers are common and difficult to treat. Calcium sulphate has been used for antibiotic delivery with success in treating osteomyelitis. Recent case series suggest success in treating osteomyelitis of the foot with a mean time to healing of 4 months, however there are few studies with a control group for comparison. This study aimed to determine if antibiotic impregnated CAS beads improved the healing of neuropathic foot ulcers with proven osteomyelitis undergoing surgical debridement.

Methods: A consecutive retrospective cohort study of 50 patients undergoing surgical debridement of neuropathic foot ulcers for osteomyelitis was performed. Exclusion criteria were amputations and microbiology findings inconsistent with osteomyelitis. Patients were analysed comparing one group having sharp surgical debridement (SD) and another having debridement and implantation of calcium sulphate (CAS) impregnated with vancomycin and gentamicin.

Results: 42 eligible patients after exclusions; 29 in the CAS group and 13 in the SD group. In the SD group the mean time to healing was 5.8 months (2 to 9 months), and in the CAS group it was 5.5 months (2 to 13 months). There was no significant difference in ulcer healing (p=0.81), time to healing (p=0.79), re-operation rate (p=0.51), length of stay (p=0.74), or mortality (p=0.13) between the two groups.

Conclusions: Ulcer healing in patients treated with antibiotic impregnated calcium sulphate beads was not significantly improved. Healing rates in both groups were similar to those in the recent literature. Sharp surgical debridement alone may be as effective as supplementation with local antibiotics in a bioabsorbable carrier.

Journal Article Type Article
Acceptance Date Mar 19, 2019
Online Publication Date Apr 18, 2019
Publication Date 2019-06
Deposit Date Mar 22, 2019
Publicly Available Date Mar 22, 2019
Print ISSN 1044-7946
Publisher HMP Communictions
Peer Reviewed Peer Reviewed
Volume 31
Issue 6
Pages 145–150
Public URL https://nottingham-repository.worktribe.com/output/1677568
Publisher URL https://www.woundsresearch.com/article/do-antibiotic-impregnated-calcium-sulfate-beads-improve-healing-neuropathic-foot-ulcers

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