Application of vancomycin-loaded bone cement in treatment of chronic traumatic osteomyelitis
Objective To compare the clinical efficacy of vancomycin-loaded bone cement and vacuum sealing drainage(VSD)in the treatment of chronic traumatic osteomyelitis.Methods Thirty one patients with chronic traumatic osteomyelitis admitted at Zhoushan Hospital of Traditional Chinese Medicine between January 2020 and March 2023 were randomly assigned to two groups,16 patients were treated with vancomycin-loaded bone cement(bone cement group)and 15 cases were treated with VSD(VSD group).The WBC,ESR,CRP,total surgical efficacy,recurrence,bacterial culture negative-transversion time and bacterial types were compared between the two groups.Both groups were followed up for a year,and their curative effects were compared too.Results The CRP and ESR levels of the bone cement group were significantly lower than those of the VSD group(15.25±4.49 vs.21.27±3.84,P＜0.05 and 17.31±5.23 vs.28.53±4.27,P＜0.05)at one month after the operation.In the bone cement group,10 cases were cured,5 cases improved and 1 case was not healed with a total effective rate of 93.75％;in the VSD group,4 cases were cured,5 cases improved,and 6 cases were not healed with a total effective rate of 60.0％(P＜0.05).There was 1 case of recurrence in the bone cement group and 4 cases in the VSD group(P＜0.05).The bacterial culture negative-transversion time in the bone cement group was shorter than that in the VSD group[(12.25±4.78)d vs.(17.27±7.42)d,P＜0.05)].The bone cement group had 7 cases of Gram-positive bacteria,5 cases of Gram-negative bacteria,and 4 cases of mixed bacterial infections;while the VSD group had 6 cases of Gram-positive bacteria,7 cases of Gram-negative bacteria,and 2 cases of mixed bacterial infections.Conclusion Compared to VSD,the vancomycin-loaded bone cement is more effective in treatment of chronic traumatic osteomyelitis,which is worth of clinical application.
Antibiotic bone cementVancomycinChronic traumatic osteomyelitis
万方数据
维普
