Application of gentamicin-collagen sponge shortened wound healing time after minor amputations in diabetic patients – a prospective, randomised trial

INTRODUCTION: Diabetic foot infections are frequently polymicrobial. The lower tissue concentration of systemically administered antibiotics in diabetic patients was reported. Collatamp(®)EG (Syntacoll GmbH Saal/Donau, Germany) is a bioabsorbable, gentamicin impregnated collagen spongeused for local treatment. The aim of this randomized trial was to assess influence of gentamicin-collagen sponge applied to a wound on surgical outcomes after minor amputations in diabetic patients. MATERIAL AND METHODS: Fifty diabetic patients indicated for minor amputation in 2009 at our surgery department were included in the study. Patients were pre-operatively randomised into two groups. Twenty-five patients in group A were treated with gentamicin impregnated collagen sponge applied into wound peri-operatively while 25 patients in group B had minor amputation without gentamicin sponge. RESULTS: There was no significant difference in the demographic data, procedures performed, diabetes duration and peripheral vascular disease severity between the groups. The median glycosylated haemoglobin was 6.0% (range: 4.6–9.5%) in group A and 6.2% (range: 4.0–8.4%) in control group B (non-significant). Median TcPO(2) level was 44 (range: 13–67) in group A and 48 (range: 11–69) in control group B (non-significant). The median of wound healing duration in group A was 3.0 weeks (range: 1.7–17.1 weeks) compared to 4.9 weeks (range: 2.6–20.0 weeks) in control group B. This was with a statistically significant difference (p < 0.05). CONCLUSIONS: Application of gentamicin impregnated collagen sponge shortened wound healing duration after minor amputations in diabetic patients by almost 2 weeks.