gms | German Medical Science

Objectives: To explore the properties of Prontosan (Prontosan liquid or gel is composed of polyethylenebiguanide and undecanoylamidopropyl betaine. Polyethylenebiguanide has a chemical structure similar to that of an antimicrobial peptide and has broad-spectrum bactericidal activity. Undecanoylcarbamidopropyl betaine, a surfactant, reduces the surface tension of tissues, facilitates the drainage of adherent purulent secretions, and inhibits bacterial reproduction, reducing bacterial species and numbers.) Efficacy of treatment of open fractures combined with multidrug-resistant bacterial infections.

Methods: The data of 31 cases of open fractures with soft tissue defects combined with multiple drug-resistant bacterial infections admitted to our department from 01/2013 to 01/2020 were retrospectively analysed. Seventeen cases in the Prontosan treatment group were treated with external fixation bracket fixation combined with negative pressure closed drainage technique or routine dressing change, while Prontosan was applied to rinse the wound or Prontosan gel dressing change. In the control group, 14 cases were treated with external fixation frame combined with negative pressure closed drainage technique or routine dressing change. The patients in both groups underwent skin flap or skin grafting to repair the wound immediately after the infection of the wound was controlled. Record the time when the bacterial culture of the wound turned negative, the survival of the flap or skin graft, and the healing of the fracture.

Results and conclusion: The difference between the general information of the two groups of patients was not statistically significant (P>0.05) and was comparable. All patients were followed up for 10–18 months after surgery, and the time for the bacterial culture of trauma to become negative was 8.3±2.1 days in the Prontosan group, which was smaller than that of 14.2±3.1 days in the control group; the time for fracture healing in the Prontosan group and the control group was 5.5±1.1 months and 6.5±1.1 months, respectively; the Samantha X-ray scores at 6 months after surgery were 5.5±0.5 and 5.1±4.7, respectively; the comparison of the above items between the two groups was not statistically significant (P＞0.05). points, and the differences between the two groups for the above items were statistically significant (P<0.05). All the flaps or implants survived, and there were no bone nonunion and chronic osteomyelitis.

The application of Prontosan in the treatment of open fractures infected by multi-resistant bacteria can effectively control the infection and promote the early repair of wounds and fracture healing.