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Chitosan Sponges Are Associated With Higher Rates of Wound Complications Compared to Calcium Sulfate Beads
Background In this study, we aimed to determine if there is a difference in the rates of wound dehiscence, delayed union, nonunion, and unanticipated surgery after the use of bioabsorbable local antibiotic-delivery systems (LADS), specifically comparing antibiotic-impregnated calcium sulfate pellets...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237341/ https://www.ncbi.nlm.nih.gov/pubmed/37273303 http://dx.doi.org/10.7759/cureus.38490 |
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author | McKee, Kelsey Easton, Joseph Mullis, Brian Hadad, Ivan |
author_facet | McKee, Kelsey Easton, Joseph Mullis, Brian Hadad, Ivan |
author_sort | McKee, Kelsey |
collection | PubMed |
description | Background In this study, we aimed to determine if there is a difference in the rates of wound dehiscence, delayed union, nonunion, and unanticipated surgery after the use of bioabsorbable local antibiotic-delivery systems (LADS), specifically comparing antibiotic-impregnated calcium sulfate pellets (Osteoset-T, Wright Medical Technology Inc., Arlington, TN, USA, hereafter referred to as beads) and chitosan sponge (Sentrex BioSponge, Bionova Medical, Germantown, TN, USA, hereafter referred to as sponges) in the management of acute and chronic extremity wounds. Methodology We conducted a retrospective comparative cohort study in the setting of a level 1 trauma center. All patients who received either beads or sponges as an adjunct to surgical debridement from January 2010 to December 2017 were included, and 136 patients met the inclusion criteria. The intervention studied was extremity wounds that were treated with bioabsorbable LADS, either beads or sponges. The main outcome measurement was wound dehiscence and the need for unanticipated surgery. Results Of the 136 patients in the study cohort, 78% (106/136) were treated with beads, and 22% (30/136) were treated with sponges. Of the 136 patients, 50 (37%) experienced wound dehiscence, and 49 patients required unanticipated surgery. Overall, 62% (31/50) of patients with wound dehiscence and 67.4% (33/49) of patients requiring unanticipated surgery were seen in the bead cohort (p = 0.0001 and 0.025, respectively). However, in multivariable analyses, we found that the odds of having wound dehiscence and undergoing unanticipated surgery were, respectively, 4.9 (p = 0.001) and 2.8 (p = 0.021) times more likely to occur in the sponge than in the bead group. Conclusions Sentrex sponges appear to be associated with higher rates of wound dehiscence and the need for unanticipated surgery compared to Osteoset beads. |
format | Online Article Text |
id | pubmed-10237341 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-102373412023-06-03 Chitosan Sponges Are Associated With Higher Rates of Wound Complications Compared to Calcium Sulfate Beads McKee, Kelsey Easton, Joseph Mullis, Brian Hadad, Ivan Cureus Plastic Surgery Background In this study, we aimed to determine if there is a difference in the rates of wound dehiscence, delayed union, nonunion, and unanticipated surgery after the use of bioabsorbable local antibiotic-delivery systems (LADS), specifically comparing antibiotic-impregnated calcium sulfate pellets (Osteoset-T, Wright Medical Technology Inc., Arlington, TN, USA, hereafter referred to as beads) and chitosan sponge (Sentrex BioSponge, Bionova Medical, Germantown, TN, USA, hereafter referred to as sponges) in the management of acute and chronic extremity wounds. Methodology We conducted a retrospective comparative cohort study in the setting of a level 1 trauma center. All patients who received either beads or sponges as an adjunct to surgical debridement from January 2010 to December 2017 were included, and 136 patients met the inclusion criteria. The intervention studied was extremity wounds that were treated with bioabsorbable LADS, either beads or sponges. The main outcome measurement was wound dehiscence and the need for unanticipated surgery. Results Of the 136 patients in the study cohort, 78% (106/136) were treated with beads, and 22% (30/136) were treated with sponges. Of the 136 patients, 50 (37%) experienced wound dehiscence, and 49 patients required unanticipated surgery. Overall, 62% (31/50) of patients with wound dehiscence and 67.4% (33/49) of patients requiring unanticipated surgery were seen in the bead cohort (p = 0.0001 and 0.025, respectively). However, in multivariable analyses, we found that the odds of having wound dehiscence and undergoing unanticipated surgery were, respectively, 4.9 (p = 0.001) and 2.8 (p = 0.021) times more likely to occur in the sponge than in the bead group. Conclusions Sentrex sponges appear to be associated with higher rates of wound dehiscence and the need for unanticipated surgery compared to Osteoset beads. Cureus 2023-05-03 /pmc/articles/PMC10237341/ /pubmed/37273303 http://dx.doi.org/10.7759/cureus.38490 Text en Copyright © 2023, McKee et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Plastic Surgery McKee, Kelsey Easton, Joseph Mullis, Brian Hadad, Ivan Chitosan Sponges Are Associated With Higher Rates of Wound Complications Compared to Calcium Sulfate Beads |
title | Chitosan Sponges Are Associated With Higher Rates of Wound Complications Compared to Calcium Sulfate Beads |
title_full | Chitosan Sponges Are Associated With Higher Rates of Wound Complications Compared to Calcium Sulfate Beads |
title_fullStr | Chitosan Sponges Are Associated With Higher Rates of Wound Complications Compared to Calcium Sulfate Beads |
title_full_unstemmed | Chitosan Sponges Are Associated With Higher Rates of Wound Complications Compared to Calcium Sulfate Beads |
title_short | Chitosan Sponges Are Associated With Higher Rates of Wound Complications Compared to Calcium Sulfate Beads |
title_sort | chitosan sponges are associated with higher rates of wound complications compared to calcium sulfate beads |
topic | Plastic Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237341/ https://www.ncbi.nlm.nih.gov/pubmed/37273303 http://dx.doi.org/10.7759/cureus.38490 |
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