Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2021-11-12 eCollection Date: 2021-01-01 DOI:10.5194/jbji-6-413-2021
Tom A G Van Vugt, Jeffrey Heidotting, Jacobus J Arts, Joris J W Ploegmakers, Paul C Jutte, Jan A P Geurts
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引用次数: 5

Abstract

Introduction: Chronic osteomyelitis is a challenging condition in the orthopedic practice and traditionally treated using local and systemic antibiotics in a two-stage surgical procedure. With the introduction of the antimicrobial biomaterial S53P4 bioactive glass (Bonalive®), chronic osteomyelitis can be treated in a one-stage procedure. This study evaluated the mid-term clinical results of patients treated with S53P4 bioactive glass for long bone chronic osteomyelitis. Methods: In this prospective multi-center study, patients from two different university medical centers in the Netherlands were included. One-stage treatment consisted of debridement surgery, implantation of S53P4 bioactive glass, and treatment with culture-based systemic antibiotics. If required, wound closure by a plastic surgeon was performed. The primary outcome was the eradication of infection, and a secondary statistical analysis was performed on probable risk factors for treatment failure. Results: In total, 78 patients with chronic cavitary long bone osteomyelitis were included. Follow-up was at least 12 months (mean 46; standard deviation, SD, 20), and 69 patients were treated in a one-stage procedure. Overall infection eradication was 85 %, and 1-year infection-free survival was 89 %. Primary closure versus local/muscular flap coverage is the only risk factor for treatment failure. Conclusion: With 85 % eradication of infection, S53P4 bioactive glass is an effective biomaterial in the treatment of chronic osteomyelitis in a one-stage procedure. A major risk factor for treatment failure is the necessity for local/free muscle flap coverage. These results confirm earlier published data, and together with the fundamentally different antimicrobial pathways without antibiotic resistance, S53P4 bioactive glass is a recommendable biomaterial for chronic osteomyelitis treatment and might be beneficial over other biomaterials.

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多中心研究S53P4生物活性玻璃治疗慢性腔型长骨骨髓炎中期临床效果
慢性骨髓炎在骨科实践中是一个具有挑战性的疾病,传统上使用局部和全身抗生素在两阶段手术过程中治疗。随着抗菌生物材料S53P4生物活性玻璃(Bonalive®)的引入,慢性骨髓炎可以在一个阶段的过程中治疗。本研究评价了应用S53P4生物活性玻璃治疗长骨慢性骨髓炎患者的中期临床效果。方法:在这项前瞻性多中心研究中,纳入了来自荷兰两所不同大学医学中心的患者。一期治疗包括清创手术、S53P4生物活性玻璃植入和基于培养的全身抗生素治疗。如果需要,由整形外科医生缝合伤口。主要结局是根除感染,并对治疗失败的可能危险因素进行二次统计分析。结果:共纳入78例慢性腔型长骨骨髓炎患者。随访至少12个月(平均46个月;标准偏差,SD, 20), 69例患者接受一期治疗。总感染根除率为85 %,1年无感染生存率为89 %。初级闭合与局部/肌肉瓣覆盖是治疗失败的唯一危险因素。结论:S53P4生物活性玻璃是一种一期治疗慢性骨髓炎的有效生物材料,其感染根除率可达85% %。治疗失败的一个主要危险因素是局部/游离肌瓣覆盖的必要性。这些结果证实了早期发表的数据,再加上没有抗生素耐药性的根本不同的抗菌途径,S53P4生物活性玻璃是治疗慢性骨髓炎的推荐生物材料,可能比其他生物材料更有益。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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