Utility of measurement of gentamicin release from PMMA beads in wound drainage fluid after in-vivo implantation.

Acute or chronic osteomyelitis in 188 patients was treated by surgical debridement and filling of the cavity with gentamicin-PMMA beads. The gentamicin concentration was measured in the total drainage fluid of the first postoperative day. There was no correlation between this concentration and the amount of implanted beads. It is impossible to predict preoperatively the gentamicin concentration which will be obtained in situ. The measurement of gentamicin concentration in the total drainage fluid of the first postoperative day and its comparison to the minimal bactericidal concentration of responsible pathogens, allow very early assessment of the effectiveness of the local antibiotherapy and if necessary, adaptation, of systemic antibiotherapy.