DOS 2018

206 · DOS Abstracts Acceptable short-term outcome after management of infected bone defects with antibiotic loaded biocomposite Magnus Petur Bjarnason Obinah, Stig Brorson, Hans Gottlieb Dept. of Orthopaedic Surgery, Herlev University Hospital; Dept. of Orthopaedic Surgery, Zealand University Hospital, Køge Background: Chronic osteomyelitis (OM) is usually treated with surgical exci- sion of infected bone and subsequent dead space management. Purpose / Aim of Study: We report short-term outcome after antibiotic load- ed biocomposite (ALB) for management of infected bone defects in a consecu- tive series of 97 patients with chronic OM treated by a multidisciplinary team at our institution. Materials and Methods: We applied a single-stage revision protocol including surgical debridement, tissue sampling, dead-space management using ALB, sta- bilization and empirical antibiotic therapy adjusted based on culturing. Closure was performed directly, with a local flap, a free flap or secondarily. In 41 pa- tients, OM followed an overlying soft- tissue infection, 30 followed surgical management of a closed fracture, 18 followed elective surgical procedures, 5 followed open fractures, 2 were spontaneous and 1 patient had previously di- agnosed OM. 71 of the included patients had systemic comorbidities (Cierny- Mader Class B hosts), 38 were diabetics, 23 were active smokers, 25 had a past history of smoking, 14 abused alcohol and 9 had a previous history of alcohol abuse. Patients were followed-up by chart review for a mean of 5.8 months (0 to 25). Findings / Results: Mean age was 66.2 years (26 to 92). 12 patients required a soft-tissue revision after a mean time of 2.2 months (0 to 12). 11 patients required bone revision after a mean time of 3.4 months (0 to 10) where the ALB was re-applied in nine cases. 6 patients required amputation after a mean time of 3.2 months (0 to 12). 2 patients died after 1 and 5 months respectively. 70 patients (73%) had no adverse advents following surgery. Conclusions: An acceptable outcome was obtained considering a heteroge- neous population with a high systemic comorbidity rate and considerable smok- ing and alcohol abuse. 147.