Fabrication of antibiotic-loaded dissolvable calcium sulfate beads: an in vitro mixing lab utilizing various antibiotic mixing formulas
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Published:2021-11-10
Issue:9
Volume:6
Page:405-412
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ISSN:2206-3552
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Container-title:Journal of Bone and Joint Infection
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language:en
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Short-container-title:J. Bone Joint Infect.
Author:
McPherson Edward J., Dipane Matthew V.ORCID, Chowdhry Madhav, Wassef Andrew J.
Abstract
Abstract. Chronic periprosthetic joint infection (PJI) is a devastating
complication that requires an aggressive eradication protocol. Local
antimicrobial delivery via dissolvable calcium sulfate (CaSO4) using
small-sized beads (3–8 mm) has been utilized as an adjunctive treatment
combined with implant exchange, radical debridement, and antimicrobial
loaded acrylic spacers. The non-exothermic setting of CaSO4 theoretically allows for any antimicrobial agent to be used, so long as
mixing methods provide a consistent fabrication within a reasonable set
time. This study performed the first in vitro mixing study, in which various
antimicrobial agents, used singularly and in combination, were mixed with a
synthetic CaSO4 product to observe and document their interactions. The
study was performed in a simulated operating room environment. We report a
standard mix formula with set times, testing 22 different antimicrobial
agents, combinations, and doses. For some antimicrobials and combinations,
set times using the standard formula were either too fast or exceedingly
slow. For these 14 antimicrobial agents and combinations, we were able to
arrive at individualized mixing methods. We present all mixing formulas and
set times. In all, we were able to establish mixing methods that incorporate
all antimicrobial agents and combinations that we have seen utilized via
surgeon-directed use.
Publisher
Copernicus GmbH
Subject
Infectious Diseases,Orthopedics and Sports Medicine,Surgery
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