The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Subjects
2.2. Preoperative Evaluations
2.3. Surgical Technique
2.4. Outcome Assessments
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Demographic Data (n = 35) | |||
---|---|---|---|
Variable | Patients with DM (n = 27) | Patients without DM (n = 8) | p-Value |
Age (yr) | 0.83 | ||
Median | 64 | 60 | |
IQR | 60.0–75.3 | 51–67 | |
Sex | 1 | ||
Male | 21 | 6 | |
Female | 6 | 2 | |
Follow-up (months) | 0.28 | ||
Median | 16.7 | 34 | |
IQR | 15.6–39.8 | 17–48.6 | |
BMI (kg/m2) | 0.529 | ||
Median | 22.7 | 22.7 | |
IQR | 21.4–24 | 21.3–27.3 | |
Comorbidity | |||
Hypertension | 14 | 2 | 0.244 |
Renal disease which requires hemodialysis | 6 | 0 | 0.299 |
Cardiac diseases | 7 | 0 | 0.16 |
Location | 0.313 | ||
Phalanx (joint not involved) | 15 | 7 | |
joint involvement | 10 | 1 | |
Metatarsals (joint not involved) | 2 | 0 | |
Maintenance of ACS | 0.858 | ||
Remained | 15 | 6 | |
Removed | 12 | 2 |
The Microbiological Findings from Cultures at Operation Room | |
---|---|
Organisms | Number |
Staphylococcus epidermidis | 2 |
Staphylococcus aureus | 8 |
MRSA | 4 |
Enterococcus faecalis | 4 |
Enterobacter cleacae | 1 |
Pseudomonas aeruginosa | 4 |
Proteus mirabilis | 2 |
Streptococcus species | 3 |
Serratia marcescens | 1 |
Klebsiella pneumoniae | 1 |
Morganella morganii | 2 |
no growth | 3 |
multiple organisms | 0 |
Total | 35 |
Comparing between ACS Retension Group and ACS Removed Group | |||
---|---|---|---|
Variable | ACS Retension Group (N = 21) | ACS Removed Group (N = 14) | p-Value |
Age (yr) | 60.00 (52.5–68) | 58.00 (53.50–73.25) | 0.96 |
mean Ankle brachial index (ABI) | 1.16 (1.08–1.22) | 1.096 (1.13–1.17) | 0.503 |
mean Toe brachial index (TBI) | 0.77 (0.48–0.89) | 1.01 (0.93) | 0.03 |
Numbers of previous surgeries before ACS insertion | 0 (0–2.5) | 0 (0.5–2) | 0.594 |
Features of Why and Where ACS Were Failed, Time to Failure (%) | |
---|---|
Variables | |
Retained ACS cases | 21 (60%) |
ACS removed cases | 14 (40%) |
Additional amputation needed | 1 (7.1%) |
Reasons why ACS were removed | |
infection not controlled | 8 (57.1%) |
wound problem (such as skin penetraion, not healed op scar) | 5 (35.7%) |
difficulty in walking | 1 (7.1%) |
Location of ACS being failed (total number of each group) | |
phalanx | 6 (out of 22, 27%) |
MPJ (joint involved) | 5 (out of 11, 45%) |
metatarsals | 2 (out of 2, 100%) |
Other * | 1 (out of 1, 100%) |
Time to failure in ACS removed groups (days) | |
mean | 348 |
Range | 2 to 2332 |
Category of Antibiotics Prescribed to the Failure Group | |
---|---|
Variable | Number |
Cephalosporins (first to third generation) | 5 |
Piperacillin/Tazobactam | 1 |
Floroquinolones | 4 |
Vancomycin | 1 |
Tigecycline | 1 |
Carbapenem | 2 |
Total | 14 |
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Woo, I.; Park, J.; Seok, H.; Kim, T.-g.; Moon, J.S.; Chung, S.M.; Park, C.H. The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis. J. Clin. Med. 2022, 11, 1976. https://doi.org/10.3390/jcm11071976
Woo I, Park J, Seok H, Kim T-g, Moon JS, Chung SM, Park CH. The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis. Journal of Clinical Medicine. 2022; 11(7):1976. https://doi.org/10.3390/jcm11071976
Chicago/Turabian StyleWoo, Inha, Jeongjin Park, Hyungyu Seok, Tae-gon Kim, Jun Sung Moon, Seung Min Chung, and Chul Hyun Park. 2022. "The Fate of Antibiotic Impregnated Cement Space in Treatment for Forefoot Osteomyelitis" Journal of Clinical Medicine 11, no. 7: 1976. https://doi.org/10.3390/jcm11071976