Laatste Studie PerOssal:
Mid-Term Results of Single-Stage Surgery for Patients with Chronic Osteomyelitis Using Antibiotic-Loaded Resorbable PerOssal® Beads
https://www.mdpi.com/2076-2607/11/7/1623
Met name de volgende paragrafen uit deze studie willen wij graag benadrukken:
PerOssal® exhibits osteoconductive properties to promote bone ingrowth into the defect. It enables loading with varying antibiotics and releases these antibiotics in a sustained manner. Nanoparticulate HA in combination with CS revealed higher porosity and higher water uptake compared to pure CS. This leads to a higher antibiotic uptake and the faster release of gentamicin and vancomycin within the first days followed by a long therapeutic duration (several weeks to months) [10,35,36].
PerOssal® enables the specific antibiotic loading of CS according to antibiograms. Considering isolated pathogens, which include Gram-negative bacteria, the need for the local and systemic delivery of antibiotics must be emphasized for such bacteria. Although other bone substitutes have these characteristics, hardened PerOssal® beads can be soaked with antibiotics immediately before use. This precludes a potential inactivation of antibiotics via hardening procedures.
In seven cases affecting the tibia, soft tissue coverage was needed [12,16,19,44,45,46,47]. Previous studies demonstrated that free flaps could increase blood flow and the delivery of antibiotics, enhance phagocytic activity and reduce bacterial counts [48]. Free flaps can also help to expedite bone healing in the early phases of repair [49].
The choice between muscle or fasciocutaneous flaps should be based on the size, depth, location of the wound, and length of the pedicle required [50].
Despite several bone void fillers can be used for local antibiotic delivery, PerOssal® holds several practical advantages compared to other BVF. First, the addition of HA increases biocompatibility and reduces inflammatory reactions induced by biomaterials made from CS alone. Second, PerOssal® can be loaded with a large range of antibiotics, based on previous culture samples and epidemiology data. Finally, it can be intra-operatively loaded with antibiotics. In conclusion, due to its good biocompatibility and antibiotic release, this composite material represents a viable adjuvant treatment in osteomyelitis.
