Stimulant Antibiotic-Impregnated Beads for the Treatment of Diabetic Foot Infection and Vascular Graft Infection

Objectives: Limited evidence has been found on the effectiveness of Stimulan antibiotic beads for the treatment of diabetic foot ulcer or vascular graft infection, and it is still yet to be explored. Our goal was to review the healing effect, the rate of infection eradication, the graft preservation, and the length of postoperative hospital stay in patients who acquired prosthetic graft infection and diabetic foot infection and hence compare the results of both. Methods: This was a retrospective review of patients implanted with Stimulan antibiotic beads at Northampton General Hospital in England from 2017 to 2019. A cohort of 22 patients aged between 45 and 92 was used in this study to compare the postoperative outcome of the wound and the duration of healing and follow-up. Results: Nineteen patients with diabetic foot infection and three patients with local vascular graft sepsis were treated with Stimulan antibiotic beads insertion. Grafts such as aorto-bifemoral bypass, femoral-to-femoral crossover, and femoral distal popliteal bypass were included. The average length of hospital stay for the patients with Stimulan beads insertion was 8 days. For healing effect, 82% of the patients (18 in 22 patients) had healed wounds within the first follow-up appointment, two patients had a partial healing effect which required further follow-up appointments, and two patients showed no signs of healing and needed re-admission. 9% of the main study group had a new onset of infection elsewhere. Conclusion: This study concluded the success of Stimulan antibiotic beads being used as the treatment of diabetic foot infection and local vascular graft sepsis, especially in patients with major vascular reconstruction. Stimulan antibiotic beads should be considered as one of the effective managements in treating vascular graft infection and diabetic foot infection.

Publication History

Article published online:
26 April 2021