Cl. Nelson et al., TREATMENT OF EXPERIMENTAL OSTEOMYELITIS BY SURGICAL DEBRIDEMENT AND THE IMPLANTATION OF BIOERODABLE, POLYANHYDRIDE-GENTAMICIN BEADS, Journal of orthopaedic research, 15(2), 1997, pp. 249-255
Osteomyelitis was induced in the radius in 77 rabbits and confirmed by
histological examination and culture. At 4 weeks, the wounds were deb
rided and the animals were treated with (a) fatty acid dimer-sebacic a
cid beads (a bioerodable composite) impregnated with 20% or (b) 10% ge
ntamicin sulfate, (c) placebo beads and intramuscular gentamicin sulfa
te, (d) placebo beads alone, or (e) debridement only. After 4 weeks, e
radication of infection was determined by histological examination and
culture. Osteomyelitis was eradicated in 93% of the animals treated w
ith the beads and 20% gentamicin, in 67% of those treated with the bea
ds and 10% gentamicin, in 25% of those treated with placebo beads and
intramuscular gentamicin, in 7% of those treated with placebo beads al
one, and in 12.5% of those treated with debridement only (p values fro
m <0.001 to 0.02). Fatty acid dimer-sebacic acid beads with gentamicin
were then implanted in noninfected rabbits, and gentamicin sulfate co
ncentrations in bone, serum, urine, and wound exudate were measured. G
entamicin sulfate was detectable in bone for as long as 8 weeks after
implantation. Levels as high as 4,746 mu g/ml were present in the woun
d exudate for the first 7 days. Levels in the serum peaked at 1.03 mu
g/ml. Urine levels peaked at 135 mu g/ml.