Akademik Veri Yönetim Sistemi
24th EFORT Congress, Vienna, Avusturya, 24 - 26 Mayıs 2023, ss.1-2, (Özet Bildiri)
Background
Revision surgeries, long-term antibiotic use and high costs in the treatment of bone infections affect all societies.
Objectives
The aim of this study is to demonstrate the efficacy and safety of a newly developed silver ion doped artificial bone graft, which has antimicrobial properties to treat the infection in this area, while filling the bone cavities that occur during the osteomyelitis process or their surgical debridement.
Study Design & Methods
In this prospective clinical study, 12 adult patients who were decided to be operated due to the diagnosis of chronic osteomyelitis, infected non-union or implant-related infection were included.
First, surgical debridement was performed on infected bone areas. If present, the infected implant was removed, and then the resulting bone cavities were filled with calcium phosphate-based artificial bone graft. Internal or external fixation was applied in cases requiring stabilization. Systemic antibiotics were given to all patients.
Healing of chronic osteomyelitis and bone tissue regeneration were evaluated clinically, laboratory and radiologically. Toxicological studies were also performed on the patients.
The disappearance of clinically infected sinus tract, cessation of wound site discharge, and termination of pain and temperature increase were evaluated in patients followed for one year. On the other hand, radiologically, bone union in 3 cortices, osteointegration of bone grafts, filling of dead space after debridement, and absence of resorption in grafts were accepted as healing criteria.
In the laboratory, infection parameters such as sedimentation, C-reactive protein, decrease in leukocyte count to normal values compared to pre-operative values and whether silver ion changes in kidney and liver function tests were examined and these values were compared with the control group.
Results
S.aureus was the most commonly grown microorganism. In 11 of 12 patients, osteomyelitis findings disappeared completely, and bone infection decreased in 1 patient.
Bone union was observed between 3-6 months in all patients except one patient. At the end of one-year follow-up, no resorption was observed in the grafts.
In 10 of 12 patients, c-reactive protein, sedimentation rate and leukocyte values decreased significantly after 1 year of follow-up (p<0.05).
No side effects suggestive of silver toxicity occurred in any of the patients, and blood silver level follow-ups were found to be normal.
Preoperative, postoperative 0, 3, 6, 9 and 12 months liver function tests (ALT, AST) and kidney function tests (urea, creatinine) values of 12 patients included in the study were studied, and high values were not observed in any patient. When the results of the patients in the control group were compared, no statistically significant difference was found (p>0.05).
Conclusions
It has been evaluated that the newly developed artificial graft with antimicrobial properties has the potential to change the paradigm because it is effective and safe to use in the infected environment.