RESUMO
In 1988, we treated 47 patients with acute or chronic osteitis by means of a new industrial collagenous sponge containing gentamicin (Sulmycin Implant) as an adjuvant measure. The local surgical management was standard: total excision of all avascular or infected soft tissue and bone, stabilization of pseudarthrosis, the improvement of local circulation and the condition of the soft tissue by means of local or free flaps before autologous bone grafting and antibiotics administered according to the test results. In cases of instability AO external fixation was used. One or two Sulmycin Implants (10 x 10 cm) containing 130 or 260 mg gentamicin were placed in the remaining small cavities or in the transplanted autologous spongy bone. Gentamicin was measured in the wound exsudate for 3-5 days; during this time we found bactericidal concentration in these exsudates. The wounds healed in 44 patients, but we had a persistent fistula in 3 patients (6.3%). We see collagen-gentamicin sponges as being very useful in the treatment of osteitis. It seems to reduce delayed bone transplantation in infected areas.