Vol 4 | Issue 2 | May – Aug 2018 | page: 15-17 | Ninad Ashok Godghate, Neha Ninad Godghate, Ashok Shyam, Krishnamohan Ananda Saindane
Author: Ninad Ashok Godghate , Neha Ninad Godghate , Ashok Shyam , Krishnamohan Ananda Saindane .
 Consultant Grace Ortho Clinic Rajiv Nagar T-Point Wardha Road, Nagpur.
 Sancheti Institute, Pune
 FICS, Consultant, Suyog Hospital, Sakri road, Dhule.
Address of Correspondence
Dr. Ninad Ashok Godghate,
Consultant Grace Ortho Clinic Rajiv Nagar T-Point Wardha Road, Nagpur.
Infection control and prevention is the first step in any orthopaedic procedure because its treatment can be challenging and complicated. Complex bony architecture, precarious blood supply and presence of biofilm make eradicating infection a difficult task. Local antibiotic delivery in such cases has proved successful as it provides high concentration of antimicrobial agents and prevents systemic toxicity that is associated with systemic antibiotic administration. Of all the options available at present for local delivery, the most commonly used is antibiotic loaded bone cement. However only heat stable antibiotics can be used with cement and studies show that amount of drug eluted from the cement decreases with time. We have attempted to address these drawbacks and make local administration of antibiotics simpler by a novel method which could be used for treatment of established infections as well as prevention of infection in open fractures. This method could allow use of sensitive and specific antibiotic in addition to providing fracture stability.
Keywords: Infection, intraosseous antibiotic delivery, cannulated schanz pin
1. Winkler H. treatment of chronic orthopaedic infection. EFFORT open reviews. 2017; Vol. 2: 110-116
2. James M, Khan W, Nannaparaju M, Bhamra J, Morgan-Jones R. Current evidence for the use of laminar flow in reducing infection rates in total joint arthroplasty. The open prthopaedic journal 2015; 9, Supple. 2: 495-498
3. Electricwala A, Dasgupta R, Rajshekharan S, Mody B, Sancheti K. Laminar air flow and air handling unit. Manual of infection control in orthopaedic surgery: operation theatre protocols and patient optimization. Jaypee. Pg. 40-49
4. Cook G, Markel D, Ren W, Webb L, McKee M, Schemitsch E. infection in orthopaedics. J. Orthop Trauma 2015; 29: S19- S23
5. Patzakis MJ, Zalavras CG. Chronic posttraumatic osteomyelitis and infected nonunion of the tibia: current management concepts. J Am Acad. Orthop Surg. 2005; 13:417–427.
6. Beenken KE, Bradney L, Bellamy W, et al. Use of xylitol to enhance the therapeutic efficacy of polymethylmethacrylate-based antibiotic therapy in treatment of chronic osteomyelitis. Antimicrob Agents Chemother. 2012; 56:5839–5844.
7. Hanssen AD. Local antibiotic delivery vehicles in the treatment of musculoskeletal infection. Clin Orthop Relat Res. 2005; 437:91–96.
8. McKee MD, Wild LM, Schemitsch EH, et al. The use of an antibiotic impregnated, osteoconductive, bioabsorbable bone substitute in the treatment of infected long bone defects: early results of a prospective trial. J Orthop Trauma. 2002; 16:622–627.
9. Ateschrang A, Albrecht D, Schroter S, Hirt B, Weise K, Dolderer J. Septic arthritis of the knee: presentation of a novel irrigation suction system tested in a cadaver study. BMC Musculoskeletal disorders. 2011; 12: 180
10. Schanz A. Ueber die nach Schenkelhalsbruchen Zuruckbleibenden geshtorungen. Munch Med Wochenschr. 1925; 51: 730-732
11. Mehta S., Humphrey JS, Dchenkmann DI, Seaber AV, Vail TP. Gentamycin distribution from collagen carrier. Journal Orthopaedic Research. 1996; 40: 749-754
12. Cierny III G. Infected tibial non-unions. The evolution of change. Clinical Orthopaedics related research, 1999; 360: 97-105
13. Mouton JW, Vinks AA: Pharmacokinetic/ pharmacodynamics modelling of antimicrobial drug effects. J Pharmacokinet Pharmacodyn 2007; 34: 727-751
14. Tsourvakas S. Local antibiotic therapy in the treatment of bone and soft tissue infections. In Stefan Danilla, editor. Selected topics in plastic reconstructive surgery. InTech ; 2012: 17-44
15. McLaren AC, Gutierrez FN, Martin M, McLemore R. Local antimicrobial treatment. In Cierny III G, McLaren AC, Wongworawat MD, editors. Orthopaedic knowledge update: Musculoskeletal infection. AAOS. Vol. 2; 2009: 95-116
16. Wahlig H, Dingeldein E, Bergmann R, Reuss K. The release of gentamycin from polymethyl methacrylate beads: an experimental and pharmacokinetic study. J Bone Joint Surgery Br 1978;60:270-275
17. Nelson CL, Hickmon SG, Skinner RA. Treatment of experimental osteomyelitis by surgical debridement and the implantation of bioerodable, polyanhydridegentamycin beads. J Orthop Res 1997; 15: 249-255
18. McLaren AC. Alternative materials to acrylic bone cement for delivery of depot antibiotics in orthopaedic infections. Clin Orthop Relat Res 2004; 427:101-106.
19. Tam VH, Kabbara S, Vo G, Schilling AN, Coyle EA. Comparative pharmacodynamics of gentamycin against staphylococcus aureus and pseudomonas aeruginosa. Antimicrob Agents Chemother 2006; 50: 2626-2631
20. Pesenti S, Blondel B, Peltier E, Adetchessi T, Dufour H, Fuentes S. Percutaneous cement-augmented screws fixation in the fractures of the aging spine: is it the solution? BioMed research international volume. 2014; 1-5
21. Buck M, Wiggins BS, Sesler JM. Intraosseous drug administration in children and adults during cardiopulmonary resuscitation. The annals of Pharmacotherapy 2007;41: 1679-1686
|How to Cite this article: Godghate N A, Godghate N N, Shyam A, Saindane K A. Cannulated schanz pin: A novel concept for intraosseous antibiotic delivery. Trauma International May- Aug 2018;4(2):15-17.|