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Defensive antibacterial coating (DAC) hydrogel with gentamycin and vancomycin for the therapy of achilles tendon infection after surgical repair without massive soft-tissue defect. Results in 8 cases

Open Access
|Dec 2023

Figures & Tables

Figure 1.

Preoperative appearance of an infection after a surgical repair of the Achilles tendon
Preoperative appearance of an infection after a surgical repair of the Achilles tendon

Figure 2.

Intraoperative appearance of an operated and infected Achilles tendon: removal of residual sutures, maintained tendon continuity
Intraoperative appearance of an operated and infected Achilles tendon: removal of residual sutures, maintained tendon continuity

Figure 3.

A and 3B: Application of DAC hydrogel after debridement of the Achilles tendon
A and 3B: Application of DAC hydrogel after debridement of the Achilles tendon

Figure 4.

Healed wound after debridement and application of DAC hydrogel
Healed wound after debridement and application of DAC hydrogel

Figure 5.

Clinical assessment two months after revision for an infected Achilles tendon: one-leg raising (isokinetic plantar flexion)
Clinical assessment two months after revision for an infected Achilles tendon: one-leg raising (isokinetic plantar flexion)

Demographic data and characteristics of patients treated with defensive antibacterial coating (DAC) with gentamycin and vancomycin for Achilles tendon infection after surgical repair Table legend: M: male; F: female; AT-Achilles tendon; ATB-cs: antibiotics; TMP-SMX – Trimethoprim -sulfamethoxazole; Post OP ATB-cs: postoperative antibiotics; NRIH: number of revisions until infection healed; HBO – hyperbaric oxygen therapy; VAC – vacuum-assisted closure dressing; CoINF: cure of infection; FU - follow-up (in months); FAAM – foot and ankle ability measures

Patient; gender; age; risk factorsCourse of treatmentPathogenPost OP ATB-csNRIHFUCoINFFAAM (max 84 points); Pre- versus postoperative function (%)
1. F; 26 yearsAT traumatic rupture; open suture; rupture of suture, 2nd suture. Infection; infection of DAC into AT sheet; revision with DACE. coliCiprofloxacin +TMP-SMX 4 weeks114YesFAAM score 87/84; 80%;
2. M; 57 years, PsoriasisAT traumatic rupture; open suture, infection; revision with DAC;S. aureus MSSACiprofloxacin + TMP-SMX 4 weeks110YesFAAM score 80/80; 95%;
3. F; 29 years, SLEAT traumatic rupture; percutaneous suture, infection; revision with DACS. aureus MSSACefuroxime + Ciprofloxacin 2 weeks19YesFAAM score 81/84; 98%;
4. F; 19 yearsAT traumatic rupture; open suture, infection; revision with DACPseudomonas aeruginosaCiprofloxacin + clindamycin 2 weeks18YesFAAM score 77/84; 70%;
5. M; 57 yearsNontraumatic AT rupture; 1 week after steroid injection; open suture; infection; HBO; revision with DACS. aureus MSSACefuroxime 10 days17YesFAAM score 83/84; 100%;
6. M; 41 yearsAT traumatic rupture; reconstruction with FiberWire suture + transfer of central part of triceps surae; infection; revision with DAC, VACKlebsiella oxytoca; Serratia marcescensCiprofloxacin 2 weeks16YesFAAM score 80/84; 80%;
7. M; 62 yearsAT traumatic rupture; open suture, revision due to suture insufficiency; infection; revision with DACEnterococcus faecalis, Finegoldia magnaCloxacillin + metronidazole 7 days130YesFAAM score 81/84; 95%;
8. M; 31 yearsAT traumatic rupture; open suture with anchor; infection, revision with DACS. aureus MSSAClindamycin, cefuroxime + RMPC 4 weeks143YesFAAM score 84/84; 95%;
Language: English
Page range: 176 - 181
Submitted on: Aug 21, 2023
Accepted on: Nov 10, 2023
Published on: Dec 31, 2023
Published by: Hirszfeld Institute of Immunology and Experimental Therapy
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2023 Ireneusz Babiak, Jakub Banasiewicz, Łukasz Luboiński, Krzesimir Sieczych, published by Hirszfeld Institute of Immunology and Experimental Therapy
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.