Clinical Analysis Of Vancomycin-loaded Calcium Sulfate And Local Irrigation In Treating Chronic Osteomyelitis

Objective: To discuss the difference between vancomycin-loaded calcium sulfate and local irrigation and their clinical effects in treating chronic osteomyelitis through clinical observations.Methods: Clinical data of 32 patients with chronic osteomyelitis admitted at the Department of Orthopedics of the First Hospital Affiliated to Shandong University of Traditional Chinese Medicine from January 2012 to July 2014 were retrospectively analyzed. The sample data of these patients were randomly divided into vancomycin-loaded calcium sulfate group(16 cases) and local irrigation group(16 cases). Both groups underwent surgeries in the corresponding manners. The postoperative observation indexes included time of operation, intraoperative bleeding loss, Visual Analogue Scale(VAS), time of wound healing, ambulation time, length of stay, evaluation of therapeutic effect, recurrence rate, etc. All data obtained were analyzed by using the SPSS17.0 statistical software.Results: A total of 32 cases were collected and followed up in this study. The mean time of wound healing of 16 patients in the vancomycin-loaded calcium sulfate group was 13.56±1.31 days, the 24 h and 48 h VAS score were 4.56±0.94, 4.63±0.62, the ambulation time was 13.19±3.78 days, while the mean time of length of stay was 23.69±10.54 days. Among them, 1 case was not healed due to fracture, and 5 cases were better. The evaluation of therapeutic effect showed that 10 cases were cured and 5 cases were better, with a reoccurrence rate of 6.25%. The mean time of wound healing of 16 patients receiving local irrigation was 15.19±2.07 days, the 24 h and 48 h VAS score were 5.19±0.66, 6.06±0.93, the ambulation time was 22.13±4.47 days, while the mean time of length of stay was 40.31±24.78 days. 4 cases of them suffered from infection in wounds, formed sinus tracts and discharged pus; 2 cases had swelling responses and pains of the wounds; 1 case was not cured due to fracture; 4 cases were better. The results of efficacy were as below: 5 cases were cured and 4 cases were better, with a reoccurrence rate of 43.75%.Conclusion:This study indicates that, compared with local irrigation, vancomycin-loaded calcium sulfate has many advantages in treating chronic osteomyelitis, such as faster wound healing, earlier ambulation, shorter length of stay, lower early Visual Analogue Scale(VAS), lower reoccurrence rate, more significant effect, etc.