Börzsei László, Mintál Tibor, Koós Zoltán, Kocsis Béla, Helyes Zsuzsanna, Kereskai László, Nyárády József
Department of Traumatology and Hand Surgery, Faculty of Medicine, University of Pécs, Pécs, Hungary.
Chemotherapy. 2006;52(2):73-9. doi: 10.1159/000092371. Epub 2006 Mar 27.
Chronic bone and soft tissue suppurations have become more frequent recently due to the increasing number of high-energy injuries. There are certain antibiotic beads available for local administration, but they cannot always be applied specifically against the pyogenic microorganisms. In the present study, a new technique of local antibiotic therapy for the treatment of infections is described. Polymethylmethacrylate (PMMA) capsules were produced and filled with 0.1 ml Tazocin (0.02 g piperacillin sodium + 0.005 g tazobactam). The efficacy of these Tazocin-filled capsules was examined in vivo using a rabbit osteomyelitis model. Chronic osteomyelitis was induced in rabbit tibia by local injection of Staphylococcus aureus. The treatment included surgical debridement and implantation of Tazocin-containing PMMA capsules into the medullar cavity (n = 12). Simple surgical debridement with no antibiotic implantation was performed in control animals (n = 7). Results were evaluated using microbiological, radiological and histological methods 14 weeks after induction of osteomyelitis. Eight weeks after the implantation of PMMA capsules, complete physical, radiological and histological healing was achieved in 7 animals, initiation of the reparative phase was observed histologically in 3 cases and no reparative signs were detected in 2 rabbits. In the control group, no significant sign of reparation could be seen in any of the cases.
由于高能损伤数量的增加，慢性骨与软组织化脓近来愈发常见。有一些可用于局部给药的抗生素珠，但它们并非总能专门针对化脓性微生物使用。在本研究中，描述了一种用于治疗感染的局部抗生素治疗新技术。制备了聚甲基丙烯酸甲酯（PMMA）胶囊，并装入0.1 ml特治星（0.02 g哌拉西林钠+0.005 g他唑巴坦）。使用兔骨髓炎模型在体内检测了这些装有特治星的胶囊的疗效。通过局部注射金黄色葡萄球菌在兔胫骨中诱发慢性骨髓炎。治疗包括手术清创，并将含特治星的PMMA胶囊植入髓腔（n = 12）。对对照动物（n = 7）进行单纯手术清创且不植入抗生素。在诱发骨髓炎14周后，使用微生物学、放射学和组织学方法评估结果。在植入PMMA胶囊8周后，7只动物实现了完全的物理、放射学和组织学愈合，3例在组织学上观察到修复期开始，2只兔子未检测到修复迹象。在对照组中，任何病例均未见到明显的修复迹象。
