Calcium sulphate as a drug delivery system in a deep diabetic foot infection

The Foot
Robert MorleyFrank Webb

Abstract

Treating diabetic foot infection is costly, time consuming and challenging for the patient and clinician alike. It requires a multidisciplinary approach to provide a favourable outcome but all too often results in amputation. We present a patient with Type 2 diabetes who attended clinic with a limb threatening foot infection complicated by osteomyelitis and requiring emergency surgery and antibiotic administration. Our patient underwent surgery by means of an incision and drainage procedure with local antibiotic administration to augment systemic antibiotics. The wound was packed with calcium sulphate (Stimulan(®) Biocomposites Ltd.) impregnated with gentamicin and vancomycin to enable high antibiotic concentrations at the site of infection. The patient made a full recovery at four months requiring only minimal bone excision to maintain a functional foot. This case demonstrates an alternative route for antibiotic administration to overcome some of the limitations of systemic administration including penetration at the site of infection, systemic toxicity, prolonged hospital admission and cost. This route of administration is being increasingly used as an alternative to systemic antibiotics at our centre.

References

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Citations

May 14, 2016·Journal of Surgical Case Reports·Hasan Raza Mohammad, Anand Pillai
Feb 21, 2018·The International Journal of Lower Extremity Wounds·Konstantinos MarkakisFrank L Bowling
Nov 20, 2016·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Chang-Chin WuKai-Chiang Yang
Dec 10, 2020·The International Journal of Lower Extremity Wounds·Christos ChatzipapasNikolaos Papanas
Aug 9, 2021·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Robert MorleyAaron Barber
Nov 11, 2021·Drug Delivery·Reem Khaled WassifSeham A Elkheshen

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