Clinical research
Application of gentamicin-collagen sponge shortened wound healing time after minor amputations in diabetic patients – a prospective, randomised trial
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Submission date: 2011-07-20
Final revision date: 2011-10-01
Acceptance date: 2012-01-02
Online publication date: 2014-05-13
Publication date: 2014-04-30
Arch Med Sci 2014;10(2):283-287
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ABSTRACT
Introduction: Diabetic foot infections are frequently polymicrobial.The lower tissue concentration of systemically administered antibiotics in diabetic patients was reported. Collatamp®EG (Syntacoll GmbH Saal/Donau, Germany) is a bioabsorbable, gentamicin impregnated collagen spongeused for local treatment. The aim of this randomized trial was to assess influence of gentamicin-collagen sponge applied to a wound on surgical outcomes after minor amputations in diabetic patients.
Material and methods: Fifty diabetic patients indicated for minor amputation in 2009 at our surgery department were included in the study. Patients were pre-operatively randomised into two groups. Twenty-five patients in group A were treated with gentamicin impregnated collagen sponge applied into wound peri-operatively while 25 patients in group B had minor amputation without gentamicin sponge.
Results: There was no significant difference in the demographic data, procedures performed, diabetes duration and peripheral vascular disease severity between the groups. The median glycosylated haemoglobin was 6.0% (range: 4.6–9.5%) in group A and 6.2% (range: 4.0–8.4%) in control group B (non-significant). Median TcPO2 level was 44 (range: 13–67) in group A and 48 (range: 11–69) in control group B (non-significant). The median of wound healing duration in group A was 3.0 weeks (range: 1.7–17.1 weeks) compared to 4.9 weeks (range: 2.6–20.0 weeks) in control group B. This was with a statistically significant difference (p < 0.05).
Conclusions: Application of gentamicin impregnated collagen sponge shortened wound healing duration after minor amputations in diabetic patients by almost 2 weeks.