Treatment of Intramedullary Osteomyelitis with Absorbable Antibiotic Calcium Sulfate

Description

The transcript describes a surgical procedure for a 57-year-old male patient with a distal tibia fracture treated with an iron rod. Dr. Janet Conway outlines the patient's current condition, which includes a draining medial sinus and multiple lytic lesions observed in radiographs. The aim of the surgery is to debride an area of osteomyelitis in the tibial canal and to administer local antibiotics.



During the procedure, the doctor carefully evaluates the patient's soft tissue, identifies areas of concern (sequestrum and lytic lesions), and develops a surgical approach that minimizes further tissue trauma. They utilize various surgical tools to access the tibia, ensuring minimal disruption to the periosteum to preserve bone health. The surgery includes confirming the condition of the bone through both visual inspection and X-ray imaging.



After soft tissue preparation and irrigation, a mixture of calcium sulfate, vancomycin, and tobramycin is prepared to treat the infected area. The antibiotics are delivered directly into the intramedullary canal via a cement gun, ensuring local infection control for at least six weeks without the need for subsequent surgeries to remove the antibiotic carriers.



The overall surgical strategy emphasizes thorough debridement, careful monitoring of the surgical field, and effective local antibiotic delivery, ultimately aiming for a healthy recovery for the patient.

Specialties