| Obstractive: Local drug delivery system can have continuum of higher local drug concentration, while keeping low serum drug level to avoid side effects of systemic administration and disadvantage of low drug concentration in the area lacking of blood supply. It is believed that local drug delivery system is one of the effective methods in the treatment of osteomyelitis. Calium alginate gel as a new type of biodegradable controlled release of antibiotics ease carrier has been abroad wide concern in recent years.The purpose of this study is to explore the calcium alginate effect in the treatment of chronic osteomyelitis, as a vancomycin carrier of biodegradable delivery system of antibiotics.Methods: In the current work, first, according to the method of Shenlin, 48 rabbits are chosed to set up animal model of chronic osteomylitis in right and left tibiaes. X-rays of the infected tibiaes, the changes of weight, observation of infectedtibiaes and s.aurous cultures are examined for evidence of osteomylitis, and s.aurous cultures are golden standarden. Second ,48 rabbits are randomly dispatched to one of the three treat groups: groupâ… , groupâ…¡, groupâ…¢; After surgical debridment, groupâ… received calium alginate implant, groupâ…¡received vancomycin-polymethymethacrylate implant, and groupâ…¢received vancomycin-calcium alginate implant. In every group, sixteen rabbits are dispatched to one of two groups, and euthanasia occured at 4 weeks, 8 weeks after operations. All rabbits are weighted before and after euthanasia. All the speciumens are subjected to gross observation, radiological, histological,bacteriological examinations and doing inhibition zone test to compare their therapeutic effect on osteomylitis.Result:1 The chang of the rabbits, weight: In the calcium alginate group, the weight of the rabbits is obviously distinctive after operation, comparing with preoperation (p<0.05). In the vancomycin-polymethymethacrylate group, the weight of the rabbits is also different after operation, comparing with preoperation (p<0.05). In the vancomycin-calcium alginate group, the weight of the rabbits is also different after operation, comparing with preoperation (p<0.05). The weight of vancomycin-calcium alginate group compares with the calcium alginate group and the vancomycin-PMMA group. The groupâ…¢is not different with the groupâ…¡(p>0.05). The groupâ…¢and the groupâ…¡are distictive with the groupâ… (p<0.05). It is indicated that the weight of groupâ…¡and groupâ…¢have recovery, but the groupâ… is opposite.2 Gross observation: The rabbits of groupâ…¡and groupâ…¢are not found soft tissue swelling, purulent exudation and sinus tract. Five rabbits are found sinus tract, nine rabbits are found purulent exudation, two rabbits are found soft tissue swelling. Through osteoporosis observation, the repairing bone defects of groupâ…¢is more obvious than groupâ…¡. The groupâ… can be found visible destruction of bone defects, irregular hyperplasia and non-repairing of bone defects. It is indicated that the groupâ…¡and groupâ…¢can be effectively treated, the groupâ…¢has more significant restoration of bone defects than groupâ…¡.3 X-ray observations: X-ray observation of the local availability of dead bone formation, bone destruction, irregular hyperplasia and soft tissue inflammatory mass shadow, with improved Norden semi-quantitative evaluation of osteomyelitis, The groupâ…¡and groupâ…¢have no significant difference (p> 0.05), The groupâ…¡and groupâ…¢have more significant difference than groupâ… (p <0.05).4 Observation of pathological section: The pathology of groupâ… can be found soft tissue infiltration of inflammatory cells, soft tissue necrosis, dead bone formation. The pathology of groupâ…¡and groupâ…¢can not be found those. Compared with the groupâ…¡, the biopsy pathology of groupâ…¢can be found osteoclast and osteoblast cells. The vancomycin-calcium alginate to treatment of chronic osteomyelitis is not only effective but also a certain capacity osteoblasts.5 Bacterial culture results: In groupâ… (pure calcium alginate), the result of bacterial culture is positive by marrow cavity tissue. The positive rate is 100%. The groupâ…¡(vancomycin-PMMA) do the culture in the same way, one is positive, the positive rate was 12.5%. The results of bacterial culture have not Staphylococcus aureus growth in groupâ…¢, the positive rate is 0. It shows that the treatment of chronic osteomyelitis is effective in groupâ…¡and groupâ…¢.6 Inhibition zone test results: In groupâ… , antibacterial Central is not found at different time. Inhibition central results of groupâ…¢are obvious different with groupâ…¡(p <0.05). It is indicated that the partial release of antibiotics of groupâ…¢is not only durable but also higher , the effect of therapy is better.Conclusion:1 Vancomycin-calcium alginate is more stable and enduring than vancomycin-PMMA in the releasing capacity of antibiotics. It makes the local area to have higher drug level and the better therapeutic effect.2 Calcium alginate is a carrier of biodegradable drug delivery system , since it can be degraded by itself, compared with PMMA , calcium alginate need not be removed by the second surgery .3 Vancomycin-calcium alginate is used to fill the bone defect, because its speed of absorption is basically the same as speed of inducing bone formation, it does not exist the bone defects,compared to remove the vancomycin-PMMA.
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