The Use of Vancomycin-impregnated Polymethylmetactylate Beads for the Treatment of Chronic Osteomyelitis

ABSTRACT

One of the current treatment methods for chronic osteomyelitis is removal of the infected and necrotic tissue to reduce the bacterial concentration as much as possible. This is performed concomitantly with antibiotic therapy. Chronic osteomyelitis (C.O.) implies chronic ischemia of the diseased bone. Thus, the treatment for C.O. requires high systemic level of antibiotics. In some cases, however, inherent undesirable adverse effects (for example, nephrotoxicity, ototoxicity, and others) may render this course of treatment difficult. Knowing that residual monomers are released from hardened bone cement, installation of antibiotic-impregnated PMMA (polymethylmethacrylate) beads in situ have been one of treatment methods of C.O. When introduced into the wound, they established an exceedingly high level of local antibiotics for prolonged period without high systemic level of antibiotics. We experienced favorable results with vancomycin-impregnated PMMA beads for the treatment of C.O. of the mandible. So, we report it with literature reviews.