Calcium Sulfate Antibiotic Impregnated Bead Implantation for the Treatment or Prevention of Deep Surgical Infection in Veterinary Medicine

Introduction: Use of calcium sulfate antibiotic impregnated beads for the prevention or treatment of surgical site infection is well established for human orthopaedic surgery, but sporadically described in veterinary medicine. The objective of this study is to report the use of calcium sulfate beads (Kerrier) for treating or preventing surgical site infection in a larger veterinary case series.

Materials and Methods: Medical records were reviewed to identify animals where implantation of calcium sulfate antibiotic impregnated beads was attempted. Descriptive data was summarized. Surgical outcome was determined by clinical signs of persistent infection and radiographic bone healing.

Results: Bead implantation was performed in 15 animals over 16 surgeries. Beads were implanted prophylactically (n = 4) and therapeutically (n = 12). The most commonly used antibiotics were amikacin (n = 9) and cefazolin (n = 5). Bead implantation failed in one case where imipenem was mixed but did not set. For the 11 cultures obtained in therapeutic cases, 1 revealed no growth and 2 revealed infections resistant to the antibiotic implanted. Persistent infection was not clinically evident on last follow-up for 12 of 14 cases with successful bead implantation. Signs of persistent infection were noted in one of two cases with resistance to the antibiotic implanted.

Discussion: Calcium sulfate antibiotic impregnated beads had good success in preventing or treating surgical site infection. Preoperative culture and sensitivity is recommended when possible, for optimal outcome.

Acknowledgment: Funding for travel to present this work will be provided by Kerrier. There was no other proprietary interest or funding provided for this project.