The Efficacy of Antibiotic-Loaded Calcium Sulfate Beads (Stimulan) in Patients with Hip Arthroplasty Infections

Dimofte, Florentin; Dimofte, Cristina; Ungurianu, Sorin; Serban, Cristina; Țocu, George; Cârneciu, Nicoleta; Filip, Iulia; Bezman, Laura; Ciuntu, Bogdan Mihnea; Abdulan, Irina Mihaela; Mihailov, Raul; Necula, Radu Dan; Sabou, Florin Lucian; Firescu, Dorel

doi:10.3390/jcm13144004

Open AccessArticle

The Efficacy of Antibiotic-Loaded Calcium Sulfate Beads (Stimulan) in Patients with Hip Arthroplasty Infections

by

Florentin Dimofte

^1,2,

Cristina Dimofte

³,

Sorin Ungurianu

²,

Cristina Serban

^1,4,

George Țocu

^1,5,†,

Nicoleta Cârneciu

^1,6,

Iulia Filip

^1,7,

Laura Bezman

⁶,

Bogdan Mihnea Ciuntu

^8,*,

Irina Mihaela Abdulan

^9,*,

Raul Mihailov

^4,†

,

Radu Dan Necula

¹⁰

,

Florin Lucian Sabou

¹⁰ and

Dorel Firescu

⁴

¹

General Surgery Clinic, “St. Apostol Andrei” County Emergency Clinical Hospital, Strada Brăilei 177, 800578 Galati, Romania

²

Department of Orthopedic, Faculty of Medicine, “Dunarea de Jos” University of Medicine and Pharmacy, 800008 Galati, Romania

³

Department Radiology, “Saint John” Emergency Children Hospital, Str. Gheorghe Asachi, Nr.2, 800487 Galati, Romania

⁴

Department of General Surgery, Faculty of Medicine, “Dunarea de Jos” University of Medicine and Pharmacy, 800008 Galati, Romania

⁵

Department of Laboratory Medicine, Faculty of Medicine, “Dunarea de Jos” University of Medicine and Pharmacy, 800008 Galati, Romania

⁶

Department of Ophtalmology, Faculty of Medicine, “Dunarea de Jos” University of Medicine and Pharmacy, 800008 Galati, Romania

⁷

Department of Anesthesia, Faculty of Medicine, “Dunarea de Jos” University of Medicine and Pharmacy, 800008 Galati, Romania

⁸

Department of General Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

⁹

Department of Medical Specialties I, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania

¹⁰

Department of General Surgery, “Transilvania” Faculty of Medicine, 500019 Brașov, Romania

^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

J. Clin. Med. 2024, 13(14), 4004; https://doi.org/10.3390/jcm13144004

Submission received: 2 June 2024 / Revised: 5 July 2024 / Accepted: 6 July 2024 / Published: 9 July 2024

(This article belongs to the Special Issue Total Joint Arthroplasty: Management and Future Opportunities)

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Abstract

Background: Given the increasing rate of infections following hip arthroplasty, one of the current options is the application of a biocomposite at the site of the infection. One of the products used is Stimulan, a completely resorbable calcium sulfate, designed to treat acute and chronic infections. This biocomposite has a controlled purity, is easy to mix with liquid, powder, and antibiotics, and can be applied directly to the site of infection, or it can be injected. Methods: We analyzed data from 76 patients, who were admitted to the County Clinical Hospital of Emergency “St. Apostol Andrei” in Galati during January 2017–September 2023, with a diagnosis of infection associated with hip arthroplasty. Results: In 69.73% of cases (52 patients), we decided to keep the implant in place. In this subgroup, Stimulan was applied in 26 cases (57.78%). Of these, 100% were cured—compared to the subgroup in which Stimulan was not applied, where this percentage was lower. All patients underwent chemical and mechanical toileting, and for 24 patients (20.27%), it was necessary to ablate the implant with or without the application of Stimulan, then reimplantation of the prosthesis. Conclusions: The patients with Stimulan had a longer average length of hospitalization, almost half of them required intervention in two periods, and a quarter required the implantation of spacers. However, the cure rate was higher, only in three people could we not control the infection, and there was no death. This study confirms the effectiveness of the treatment when using a biocomposite in addition to the classical treatment for both acute and chronic cases.

Keywords: stimulan; calcium sulfate; wound infection; hip arthroplasty; biocomposite

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MDPI and ACS Style

Dimofte, F.; Dimofte, C.; Ungurianu, S.; Serban, C.; Țocu, G.; Cârneciu, N.; Filip, I.; Bezman, L.; Ciuntu, B.M.; Abdulan, I.M.; et al. The Efficacy of Antibiotic-Loaded Calcium Sulfate Beads (Stimulan) in Patients with Hip Arthroplasty Infections. J. Clin. Med. 2024, 13, 4004. https://doi.org/10.3390/jcm13144004

AMA Style

Dimofte F, Dimofte C, Ungurianu S, Serban C, Țocu G, Cârneciu N, Filip I, Bezman L, Ciuntu BM, Abdulan IM, et al. The Efficacy of Antibiotic-Loaded Calcium Sulfate Beads (Stimulan) in Patients with Hip Arthroplasty Infections. Journal of Clinical Medicine. 2024; 13(14):4004. https://doi.org/10.3390/jcm13144004

Chicago/Turabian Style

Dimofte, Florentin, Cristina Dimofte, Sorin Ungurianu, Cristina Serban, George Țocu, Nicoleta Cârneciu, Iulia Filip, Laura Bezman, Bogdan Mihnea Ciuntu, Irina Mihaela Abdulan, and et al. 2024. "The Efficacy of Antibiotic-Loaded Calcium Sulfate Beads (Stimulan) in Patients with Hip Arthroplasty Infections" Journal of Clinical Medicine 13, no. 14: 4004. https://doi.org/10.3390/jcm13144004

APA Style

Dimofte, F., Dimofte, C., Ungurianu, S., Serban, C., Țocu, G., Cârneciu, N., Filip, I., Bezman, L., Ciuntu, B. M., Abdulan, I. M., Mihailov, R., Necula, R. D., Sabou, F. L., & Firescu, D. (2024). The Efficacy of Antibiotic-Loaded Calcium Sulfate Beads (Stimulan) in Patients with Hip Arthroplasty Infections. Journal of Clinical Medicine, 13(14), 4004. https://doi.org/10.3390/jcm13144004

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The Efficacy of Antibiotic-Loaded Calcium Sulfate Beads (Stimulan) in Patients with Hip Arthroplasty Infections

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