Becker P L, Smith R A, Williams R S, Dutkowsky J P
University of Tennessee-Campbell Clinic, Department of Orthopaedic Surgery, University of Tennessee, Memphis.
J Orthop Res. 1994 Sep;12(5):737-41. doi: 10.1002/jor.1100120517.
The rates of elution of tobramycin in vitro were compared for polymethylmethacrylate beads impregnated with the powder form and an alternative biodegradable substance, sponge collagen. The impregnated polymethylmethacrylate beads initially had a lower zone of inhibition, but the rate of release was slow in comparison with that of the impregnated sponge collagen. The sponge collagen delivered a higher dose faster and with a shorter duration than the polymethylmethacrylate beads with the same antibiotic concentration in vitro, but the beads delivered a therapeutic concentration for longer periods. Because it deteriorates rapidly, sponge collagen may be unsatisfactory as an agent of antibiotic delivery in patients who have chronic osteomyelitis; however, it may be useful for patients who have acute trauma with highly contaminated bone or soft tissue, or during hemiarthroplasty revision, to deliver a high local concentration of antibiotic for a short period of time.
对浸渍有粉末状妥布霉素的聚甲基丙烯酸甲酯珠粒和另一种可生物降解物质海绵胶原在体外的洗脱速率进行了比较。浸渍的聚甲基丙烯酸甲酯珠粒最初抑菌圈较小,但与浸渍的海绵胶原相比,释放速率较慢。在体外相同抗生素浓度下,海绵胶原比聚甲基丙烯酸甲酯珠粒更快、更短时间内释放更高剂量,但珠粒能在更长时间内维持治疗浓度。由于海绵胶原迅速降解,对于患有慢性骨髓炎的患者,作为抗生素递送剂可能不理想;然而,对于有骨或软组织高度污染的急性创伤患者,或在半关节置换翻修术中,在短时间内递送高局部浓度抗生素可能是有用的。