Department of Orthopedics and Traumatology, Guangdong Second Provincial General Hospital, the Second Clinical Medical School of Southern Medical University, 466 Xingang Road C., Haizhu District, Guangzhou, 510317, China.
Department of Nursing, Southern Medical University Nanfang Hospital, No.1838, Guangzhou Ave. North, Baiyun District, Guangzhou, China.
Foot Ankle Int. 2022 Mar;43(3):331-342. doi: 10.1177/10711007211049768. Epub 2021 Nov 1.
Chronic osteomyelitis of calcaneus is not rare but is very hard to treat. Irrigation-suction and antibiotic-impregnated calcium sulfate following debridement are commonly used in managing chronic osteomyelitis, but their effects have rarely been compared. We aimed to compare the effectiveness of antibiotic-impregnated calcium sulfate with irrigation-suction in the treatment of patients with chronic calcaneal osteomyelitis.
From January 2011 to June 2018, adult patients at our institute with chronic osteomyelitis receiving treatment of either antibiotic-impregnated calcium sulfate (CS group) or irrigation-suction (IS group) following thorough debridement were screened and selected according to the inclusion and exclusion criteria. The clinical presentation, laboratory tests, complications, and the ultimate single-staged cure rate and recurrence were compared.
A total of 61 patients, including 41 in the CS group and 20 in the IS group, were included in our study. Of the patients, 85.4% in the CS group and 60.0% in the IS group ( = .006) were successfully cured in the single stage, respectively, without infection recurrence. Lower infection recurrence rates with shorter hospital stay were found in the CS group than the IS group. Inflammatory biomarkers after surgery with both treatments were slightly decreased and not significantly different from preoperative or between-groups postoperative. Exudate from incision was found primarily in the CS group.
This study demonstrates that both antibiotic-impregnated calcium sulfate and irrigation-suction after careful and thorough surgical debridement are generally effective in treating chronic calcaneal osteomyelitis. Antibiotic-impregnated calcium sulfate achieved a higher single-staged cure rate but was associated with an increased postoperative wound exudate.
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跟骨慢性骨髓炎并不少见，但很难治疗。清创后灌洗-吸引和载抗生素硫酸钙常用于治疗慢性骨髓炎，但两者的疗效鲜有比较。我们旨在比较载抗生素硫酸钙与灌洗-吸引在治疗慢性跟骨骨髓炎患者中的疗效。
从 2011 年 1 月至 2018 年 6 月，根据纳入和排除标准，我们筛选并选择了在我院接受彻底清创后接受载抗生素硫酸钙（CS 组）或灌洗-吸引（IS 组）治疗的慢性骨髓炎的成年患者。比较了临床表现、实验室检查、并发症以及最终单阶段治愈率和复发率。
共有 61 例患者，CS 组 41 例，IS 组 20 例，纳入我们的研究。CS 组 85.4%的患者和 IS 组 60.0%的患者（ =.006）在单阶段成功治愈，且无感染复发。CS 组的感染复发率较低，住院时间较短。两种治疗方法的术后炎症标志物均略有下降，与术前或组间术后相比无明显差异。CS 组切口渗液较多。
本研究表明，仔细彻底的手术清创后，载抗生素硫酸钙和灌洗-吸引均能有效治疗慢性跟骨骨髓炎。载抗生素硫酸钙的单阶段治愈率较高，但术后伤口渗出物增加。
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