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Review
. 2021 May 4;6(5):297-304.
doi: 10.1302/2058-5241.6.200083. eCollection 2021 May.

Review of calcium-sulphate-based ceramics and synthetic bone substitutes used for antibiotic delivery in PJI and osteomyelitis treatment

Razvan Ene  1   2 , Mihai Nica  1   3 , Dragos Ene  1   2 , Adrian Cursaru  1   3 , Catalin Cirstoiu  1   3
Affiliations
Review

Review of calcium-sulphate-based ceramics and synthetic bone substitutes used for antibiotic delivery in PJI and osteomyelitis treatment

Razvan Ene et al. EFORT Open Rev. .

Abstract

Infection in orthopaedic and trauma surgery remains a destructive complication with particularly challenging diagnosis and treatment due to bacterial antibiotic resistance and biofilm formation.Along with surgical debridement and systemic antibiotics, an important type of adjuvant therapy is local antibiotic delivery, with the purpose of eliminating bacterial colonization and biofilm development.Calcium sulphate, as a synthetic absorbable biomaterial used for local antibiotic delivery, has experienced an increasing popularity during the last decade, with multiple promoted advantages such as predictable antibiotic elution kinetics, complete and quick biodegradation, good biocompatibility, and limited associated complications.A series of commercially available antibiotic-delivery systems based on calcium sulphate are under investigation and in clinical use, with different presentations, compositions, and application techniques.The current article presents the main available calcium-sulphate-based products and the existing data about the clinical and preclinical research results, stemming from their implementation as local antibiotic carriers for surgical site and implant-associated infections treatment and prevention. Cite this article: EFORT Open Rev 2021;6:297-304. DOI: 10.1302/2058-5241.6.200083.

Keywords: antibiotic delivery; biofilm; biomaterial; calcium sulphate; infection.

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Conflict of interest statement

ICMJE Conflict of interest statement: The authors declare no conflict of interest relevant to this work.

Figures

Fig. 1
Fig. 1
Preparation of calcium sulphate (CS) beads (Stimulan®) by combining the antibiotic-loaded aqueous solution with CS hemihydrate powder.
Fig. 2
Fig. 2
Antibiotic-loaded calcium sulphate beads (Stimulan®) implanted around the endoprosthesis for infection prophylaxis.
See this image and copyright information in PMC

References

    1. de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009;37:387–397. - PubMed
    1. Kurtz SM, Lau E, Schmier J, Ong KL, Zhao K, Parvizi J. Infection burden for hip and knee arthroplasty in the United States. J Arthroplasty 2008;23:984–991. - PubMed
    1. Bohl DD, Sershon RA, Fillingham YA, Della Valle CJ. Incidence, risk factors, and sources of sepsis following total joint arthroplasty. J Arthroplasty 2016;31:2875–2879.e2. - PubMed
    1. Oliveira PR, Carvalho VC, da Silva Felix C, de Paula AP, Santos-Silva J, Lima AL. The incidence and microbiological profile of surgical site infections following internal fixation of closed and open fractures. Rev Bras Ortop 2016;51:396–399. - PMC - PubMed
    1. Hu Q, Zhao Y, Sun B, Qi W, Shi P. Surgical site infection following operative treatment of open fracture: incidence and prognostic risk factors. Int Wound J 2020;17:708–715. - PMC - PubMed

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