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Comparative study on usefulness of gentamycin-containing collagen implants in the treatment of patients with osteitis and osteomyelitis of the craniofacial skeleton.

Abstract <b>Introduction and objective.</b> A reduction in incidences of peri-surgical complications due to infections is achieved by antibiotic prophylaxis The objective of the study was to assess the usefulness of gentamycin-containing collagen implants (GCCI) in the treatment of patients with osteitis and osteomyelitis of the craniofacial skeleton. <b>Materials and method.</b> The retrospective study included 103 patients with osteitis and osteomyelitis. 54 patients were treated intra-operatively with GCCI (Garamycin, EusaPharma, Europe). 49 patients were treated according to standard procedures. Light microscopy and in vitro culture techniques were applied for bacteria specific identification, and to investigate the resistance of detected microbiota to antibiotics. Patients received one dose of antibiotic pre-operatively. Post-operative antibiotic treatment was administered individually, according to clinical course and microbiological tests. The patients were followed-up on days 3, 7 and 14 after discharge for local complications; radiographic follow-up was performed 3, 6 and 12 months after surgery. <b>Results</b>. The course of post-operative antibiotic therapy was shorter in GCCI patients than in the control group (median 1 vs. 7 days); they also required shorter hospitalization (median 3 vs. 4 days). Implantation of GCCI significantly reduced the incidence of local complications (OR 0.30, 95%CI 0.11-0.83, p<0.0001), independently of the use of postoperative antibiotic therapy. On follow-up after 3-12 months, all patients presented with good soft tissue and bone healing. <b>Conclusions</b>. The results of this comparative study advocate the use of GCCI in osteomyelitis of various origin in oral and maxillofacial surgery, as they seemed to reduce the incidence of local complications, shorten antibiotic administration time and hospital stay.
PMID
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Authors

Mayor MeshTerms
Keywords

Gentamycin-containing collagen treatment patients

comparative study

craniofacial skeleton

osteomyelitis

Journal Title annals of agricultural and environmental medicine : aaem
Publication Year Start




PMID- 28664712
OWN - NLM
STAT- MEDLINE
DA  - 20170630
DCOM- 20170710
LR  - 20170713
IS  - 1898-2263 (Electronic)
IS  - 1232-1966 (Linking)
VI  - 24
IP  - 2
DP  - 2017 May 11
TI  - Comparative study on usefulness of gentamycin-containing collagen implants in the
      treatment of patients with osteitis and osteomyelitis of the craniofacial
      skeleton.
PG  - 299-302
LID - 72531 [pii]
LID - 10.5604/12321966.1235182 [doi]
AB  - &lt;b&gt;Introduction and objective.&lt;/b&gt; A reduction in incidences of peri-surgical
      complications due to infections is achieved by antibiotic prophylaxis The
      objective of the study was to assess the usefulness of gentamycin-containing
      collagen implants (GCCI) in the treatment of patients with osteitis and
      osteomyelitis of the craniofacial skeleton. &lt;b&gt;Materials and method.&lt;/b&gt; The
      retrospective study included 103 patients with osteitis and osteomyelitis. 54
      patients were treated intra-operatively with GCCI (Garamycin, EusaPharma,
      Europe). 49 patients were treated according to standard procedures. Light
      microscopy and in vitro culture techniques were applied for bacteria specific
      identification, and to investigate the resistance of detected microbiota to
      antibiotics. Patients received one dose of antibiotic pre-operatively.
      Post-operative antibiotic treatment was administered individually, according to
      clinical course and microbiological tests. The patients were followed-up on days 
      3, 7 and 14 after discharge for local complications; radiographic follow-up was
      performed 3, 6 and 12 months after surgery. &lt;b&gt;Results&lt;/b&gt;. The course of
      post-operative antibiotic therapy was shorter in GCCI patients than in the
      control group (median 1 vs. 7 days); they also required shorter hospitalization
      (median 3 vs. 4 days). Implantation of GCCI significantly reduced the incidence
      of local complications (OR 0.30, 95%CI 0.11-0.83, p&lt;0.0001), independently of the
      use of postoperative antibiotic therapy. On follow-up after 3-12 months, all
      patients presented with good soft tissue and bone healing. &lt;b&gt;Conclusions&lt;/b&gt;.
      The results of this comparative study advocate the use of GCCI in osteomyelitis
      of various origin in oral and maxillofacial surgery, as they seemed to reduce the
      incidence of local complications, shorten antibiotic administration time and
      hospital stay.
FAU - Zawadzki, Pawel J
AU  - Zawadzki PJ
AD  - Clinic of Cranio-Maxillo-Facial and Oral Surgery and Implantology, Medical
      University of Warsaw, Warsaw, Poland.
FAU - Perkowski, Konrad
AU  - Perkowski K
AD  - Department of Orthodontics, Medical University of Warsaw, Warsaw, Poland.
FAU - Kotlarski, Michal
AU  - Kotlarski M
AD  - Clinic of Cranio-Maxillo-Facial and Oral Surgery and Implantology, Medical
      University of Warsaw, Warsaw, Poland.
FAU - Pietruczuk-Padzik, Anna
AU  - Pietruczuk-Padzik A
AD  - Department of Pharmaceutical Microbiology, Medical University of Warsaw, Warsaw, 
      Poland.
FAU - Chomicz, Lidia
AU  - Chomicz L
AD  - Department of Medical Biology, Medical University of Warsaw, Warsaw, Poland.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Poland
TA  - Ann Agric Environ Med
JT  - Annals of agricultural and environmental medicine : AAEM
JID - 9500166
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Gentamicins)
RN  - 9007-34-5 (Collagen)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/*administration &amp; dosage
MH  - Antibiotic Prophylaxis
MH  - Collagen/*therapeutic use
MH  - Craniofacial Abnormalities
MH  - Facial Bones/*surgery
MH  - Female
MH  - Gentamicins/*administration &amp; dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Osteitis/complications/*surgery
MH  - Osteomyelitis/complications/*surgery
MH  - Retrospective Studies
MH  - Skull/*surgery
MH  - Surgical Wound Infection/etiology/*prevention &amp; control
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Gentamycin-containing collagen treatment patients
OT  - comparative study
OT  - craniofacial skeleton
OT  - osteomyelitis
EDAT- 2017/07/01 06:00
MHDA- 2017/07/14 06:00
CRDT- 2017/07/01 06:00
AID - 72531 [pii]
AID - 10.5604/12321966.1235182 [doi]
PST - ppublish
SO  - Ann Agric Environ Med. 2017 May 11;24(2):299-302. doi: 10.5604/12321966.1235182.