Vancomycin-calcium Sulfate For Chronic Osteomyelitis

Objective: To investigate the effect of Vancomycin-calcium sulfate on chronic staphylococcal osteomyelitis healing, compared with Vancomycin- polymethylmethacrylate (PMMA) .Methods: In the current work, 24 rabbits were chosen to set up animal model of chronic osteomyelitis in left tibiae. X- rays of the infected tibiae, the changes of weight, observations of infected tibiae and S. aureus cultures were examined for evidence of osteomyelitis, and S. aureus cultures were golden standard. Animals were randomly dispatched to one of the three treat groups:A bank, B bank and C bank;After surgical debridment, A bank received polymethylmethacrylate implant, B bank received Vancomycin- polymethylmethacrylate implant and C bank received Vancomycin-calcium sulfate implant. Drainage fluid and blood of B bank and C bank were collected(0.5h, 1.0h, 1.5h, 2.0h, 4h, 6h, 12h, 24h, 48h﹍after operation) to measure the Vancomycin levels;The urine of B bank and C bank were also been collected(1h, 2h, 6h, 12h, 24h, 48h, 4d,7d﹍).All rabbits were weighted. In every bank, eight rabbits were dispatched to one of the four groups, and euthanasia occurred at 15 days,. 30 days, 45 days, 60 days after operations;All rabbits were weighted, S. aureus cultured and observed again, bone and muscle were cutted to do inhibition zone test.Results: Osteomyelitis was obtained in 24 of the 24 animals(100%). Antibiotic release in C band was more stable than in B band and the Vancomycin level of C band was higher than B band(P<0. 05), but in blood and urine, both B and C band were low than in drainage fluid. The mortality of B and C bands were 0%, but A band was 62. 5%;The positive of S. aureus culture of A band was 87. 5%, B band was 25% and C band was 0%;And inhibition zone test of bone and muscle showed that B band was better than A band and the antimicrobial activity of both bands were continued until 2 months later.Conclusion: The effect of Vancomycin-calcium sulfate on chronic staphylococcal osteomyelitis healing is better than Vancomycin- polymethylmethacrylate.