Sidhu Sahil Prabhnoor, White Neil Jeffrey
J Am Acad Orthop Surg Glob Res Rev. 2019 Oct 15;3(10). doi: 10.5435/JAAOSGlobal-D-18-00042. eCollection 2019 Oct.
We describe the use of local antibiotics to salvage an infected below-knee amputation in a diabetic patient and prevent the need to convert to the above-knee level. After débridement, an antibiotic tibial "dowel" was fashioned and inserted into the intramedullary canal before closure. The wound was fully healed after four months, and the patient remained satisfied at 15 months.
This case report offers an adjunct to the conventional management of diabetic stump infections. The addition of an antibiotic spacer could offer an alternative to a higher level of amputation and improve the survival rates of below-knee amputation in this difficult population.
我们描述了使用局部抗生素挽救一名糖尿病患者膝下截肢部位感染并避免转为膝上截肢的情况。清创后，制作了一根抗生素胫骨“髓内钉”并在缝合前插入髓腔。四个月后伤口完全愈合，患者在15个月时仍感满意。
本病例报告为糖尿病残端感染的传统治疗提供了一种辅助方法。添加抗生素间隔物可为更高水平的截肢提供替代方案，并提高这一困难人群膝下截肢的存活率。
