Case study

Osteomyelitis caused by MRSA

Courtesy of Dr. Daniel Schlatterer
Atlanta Medical Center, Atlanta, Georgia

Clinical particulars

40-year old male sustained an open calcaneus fracture after a 20 foot fall. Initial surgery was an irrigation and debridement with definitive fixation 10 days after injury. 6 months later patient presented with an infected non-union and hardware failure. Cultures were positive for MRSA.

Treatment

Stage 1
Hardware removal, debridement of grossly infected bone and soft tissues. STIMULAN Rapid Cure was used to fill the resulting dead space. I.V. antibiotics for 8 weeks.

Outcome

Infection eradicated, soft tissues healed and foot ready for subtalar fusion.

Treatment

Stage 2
8 weeks of I.V. antibiotics completed during stage 1. 4 weeks later (no I.V. antibiotics during this time period) infectious labs were normal and clinical appearance normal. Subtalar fusion procedure performed.

STIMULAN Rapid Cure was used to fill the resulting dead space. I.V. antibiotics restarted as prophylaxis. 

2 months later hardware removed again due to positive blood cultures. Calcaneus cultures were negative at time of second hardware removal, PICC line catheter tip culture positive. I.V. antibiotics again for 8 weeks.

Outcome

Infection in open calcaneus fractures is common and in some series amputation rates exceed 50%. For this patient a 2 stage approach was utilized to treat the infected non-union. Removal of hardware and aggressive debridement of the bone. The dead space was managed with STIMULAN. This patient is now weight bearing as tolerated and clinically no signs of infection.

 

 

For indications, contraindications, warnings and precautions see Instructions for Use.  The treating physician is responsible for deciding the type and quantity of antibiotic used. Concurrent use of locally administered antibiotics may affect the setting time. The mixing of antibiotics with the STIMULAN Kit / STIMULAN Rapid Cure device has not been assessed by a European medicines Competent Authority and is considered off-label usage of the medicinal product and of the device. To do so is at the professional risk of the surgeon / healthcare professional.

This brochure may include the use of STIMULAN or techniques that go beyond the current clearance / approval granted by the relevant regulatory authority. Please contact your local representative for further information.

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Patents granted: GB2367552, EP 1204599 B1, US 6780391, EP 2594231 B1, US 8883063, ZL 201210466117.X, GB2496710/Patents pending: GB 1502655.2, EP 16154210.5, US 15/040075, CH 201610089710.5

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