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  • ANTIBIOTICLOADEDCERAMICSTERNUMFORSTERNALREPLACEMENTDURINGREFRACTORYDEEPSTERNALWOUNDINFECTION

    JérémyTRICARD,AnaëlleCHERMAT,EricDENES,SouleimanELBALKHI,FrançoisBERTIN

    ThoracicandCardiovascularSurgerydepartmentLIMOGESUniversityHospital,France

    Objective:Sternumreconstructionafteritsdestructionduringrefractorydeepsternalwoundinfection(DSWI)mainlyreliesonvacuum-assistedclosuretherapy(VAC)andmuscleflapswhichhassome pitfalls. We report here the use of an antibiotic loaded prosthesis for sternalreplacementduringDSWI(CERAMIL®).Thedeviceisaporousaluminasternumloadedwithgentamicin.Theaimistoobtainamechanicalreplacementofthesternumassociatedtoitsbacterialprotectionduringimplantationthankstoantibioticlocalrelease.

    Table2:Localgentamicinconcentrationexceededtheoneneededforitsefficacywhilenoantibioticwasfoundintheblood

    Conclusions:ThesethreeimplantationsarepromisingforpatientswithsternaldestructionafterDSWI,offeringaprotectionagainstbacteria.

    Methods:ThisdevicewasimplantedinthreemalepatientswithDSWIandpersistentinfectedsternaldehiscencefollowingcoronaryheartby-pass.

    H1 H24 FromH1toH48Antibiotic Loaded

    dose(mg)

    Localconcentration(mg/L)

    Comparisontotheneededconcentration

    Localconcentration(mg/L)

    Comparisontotheneededconcentration

    Antibioticsampledinblood(mg/L)

    #2 Gentamicin 320 1500 >175folds 395 >50folds 260folds 37 >5folds


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