Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

State-of-the-Art Analysis of Antibiotic-Loaded Calcium Sulfate Beads in Plastic and Reconstructive Surgery: An Updated Systematic Review

Version 1 : Received: 27 April 2024 / Approved: 29 April 2024 / Online: 29 April 2024 (09:42:57 CEST)

How to cite: Marcasciano, M.; Astolfi, M.; Fiorillo, M. A.; Greto Ciriaco, A.; Stagno d'Alcontres, F.; Russo, A.; Losco, L.; Vitagliano, T.; Fanelli, B.; Casella, D.; Greco, M. State-of-the-Art Analysis of Antibiotic-Loaded Calcium Sulfate Beads in Plastic and Reconstructive Surgery: An Updated Systematic Review. Preprints 2024, 2024041896. https://doi.org/10.20944/preprints202404.1896.v1 Marcasciano, M.; Astolfi, M.; Fiorillo, M. A.; Greto Ciriaco, A.; Stagno d'Alcontres, F.; Russo, A.; Losco, L.; Vitagliano, T.; Fanelli, B.; Casella, D.; Greco, M. State-of-the-Art Analysis of Antibiotic-Loaded Calcium Sulfate Beads in Plastic and Reconstructive Surgery: An Updated Systematic Review. Preprints 2024, 2024041896. https://doi.org/10.20944/preprints202404.1896.v1

Abstract

Calcium sulphate (CS) is currently used as a bioabsorbable, completely synthetic and sterile material in the management of infected tissues and dead spaces (DS) mainly resulting from surgical procedures. Residual DS in the postoperative, may create an environment where hematomas fill up and bacteria can proliferate, leading to a high incidence of postoperative infections. Considering the available reviews in the literature, CS has been mainly studied in orthopedic surgery mostly giving brilliant results and low complication rates. Nowadays, orthopedists avail it in the form of pearls both as a bone void filler and as an “off-label” delivery agent for antibiotics in arthroplasty, chronic osteomyelitis and open fractures, paving the way of its application in many other contexts given its natural dis-position to biodegradation. In the last years, CS beads have been gaining ground in the general, vascular and endocrinological surgical specialties. Despite its clear potential and the increasing number of scientific evidences on the safety and effectiveness of CS application in the prophylaxis and treatment of infections, there are not many studies reporting on its application in fields other than orthopedics, with a substantial paucity in plastic and reconstructive surgery literature. This is some-how surprising, since reconstructive surgery often deals with complex wounds secondary to bone and soft tissue exposure, suture dehiscence, trauma, and surgical site infections. As far as we know this is the first updated systematic review assessing the state of the art, indications and new perspectives on the application of CS beads in plastic and reconstructive surgery.

Keywords

 Calcium sulfate, Calcium sulphate, Calcium sulfate beads, Calcium sulphate beads, Stimulan, Stimulan beads, Antibiotic beads, Calcium sulphate beads and Plastic Surgery 

Subject

Medicine and Pharmacology, Surgery

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