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Preparation and Use of Antibiotic-Impregnated Beads for Orthopaedic Infections

Localized antibiotic therapy using antibiotic-impregnated bone cement has become an attractive option for treating severe orthopaedic infections. In the form of beads and spacers, antibiotic-impregnated cement can provide high concentrations of local antibiotic to a wound with minimal systemic toxic exposure. Clinical uses of antibiotic beads and spacers include prophylaxis for open fractures and total joint arthroplasties and in the treatment of acute and chronic osteomyelitis. Limited clinical data indicate that the use of antibiotic beads decreases the incidence of adverse effects observed with systemic antibacterial therapy. A detailed description of the"bead pouch"technique for the prevention of infection in open fractures is provided in this article.