Antibacterial Bioactive Glass, S53P4, for Chronic Bone Infections - A Multinational Study.

Osteomyelitis is an infectious process in bone that occasionally leads to bone destruction. Traditionally, the surgical treatment procedure is performed in combination with systemic and local antibiotics as a two-stage procedure that uses autograft or allograft bone for filling of the cavitary defect. Bioactive glass (BAG-S53P4) is a bone substitute with proven antibacterial and bone bonding properties.One hundred and sixteen patients who had verified chronic osteomyelitis was treated using BAG-S53P4 as part of the treatment. Most of the patients had previously undergone numerous procedures, sometimes for decades. A register of patient data obtained from 11 centers from Finland, Italy, the Netherlands, Germany, Azerbaijan and Poland was set-up and continuously maintained at Helsinki University Central Hospital.The location of the osteomyelitis was mainly in the tibia followed by the femur and then the calcaneus. The median age of the patients was 48 years (15-87). The patients were either treated according to a one-stage procedure without local antibiotics (85 %) or by a two-stage procedure using antibiotic beads in the first procedure (15 %). The minimum follow-up was 1 year (12-95 months, median 31).The cure rate was 104/116, the total success rate 90 % and most of the patients showed a rapid recovery.The study shows that (BAG-S53P4) can be used in a one-stage procedure in treatment of osteomyelitis with excellent results.

[Reconstructive surgery of leg ulceration]. / Säärihaavan korjaava kirurgia.

The great majority of chronic leg ulcers are caused by disturbances of venous and arterial circulation in the lower extremities. Diagnostics and treatment of ulcers require multiprofessional collaboration. The cornerstone of the treatment is conservative treatment intervening in the underlying causes of the ulceration. If the ulcer is large or recovery does not take place with appropriate conservative therapy, reconstructive surgery may come into question, i.e. surgical excision of the ulcer and its covering with a skin graft.

[Treatment of a contaminated wound]. / Likaisen haavan hoito.

Cleaning of wounds is considered as the most important part of the local treatment. A contaminated wound is conceived as a poorly healing one, and cleaning has been a natural part of the local treatment already prior to the understanding of wound healing mechanisms on the cellular level. Modern systematic wound treatment comprises of four sectors: cleaning of the wound, inflammation control, management of humidity balance, and supporting of the growth of new epithelium. Wounds received outdoors, particularly in the summer, are often contaminated, whereby special attention should be paid on the primary care.

[Treatment path of wound patient in the HUC medical care district]. / Haavapotilaan hoitopolku HYKS:n sairaanhoitoalueella.

Unorganized care on chronic wounds is expensive. Resources are focused on the care of complicated wounds, although a significant proportion of the wounds could be prevented or treated at an early stage. Good care is cost-effective, a delayed care and inoperative treatment chain will waste money and resources. Specialization of medical and nursing staff in wound care will improve treatment outcome. Prerequisites for the necessary care must be guaranteed by creating a complete treatment path for problematic wounds in the capital region.