44-year-old female presented with persistent and severe pain of the right arm. She had a history of infection following a nailing of the humerus 15 years ago. She has grown Staphylococcus aureus in the past and has had a number of flare-ups over the years. 7 years ago, she had a fenestration and a sequestrum removed, and MSSA was isolated.
Treatment
She was treated with an open sequestrectomy through a bone window, made through a deltopectoral approach. 10cc of STIMULAN mixed with antibiotic was formed into beads and administered for dead space management and to treat the bacterial infection. A suction drain was placed for 24 hours. Systemic antibiotics were administered intravenously for 6 weeks.
Outcome
At 6 month follow-up, the patient had returned to normal activities without symptoms or signs suggesting persistence or recurrence of infection. CRP = 1. On the x-ray, the bone window and cavity appeared filled with newly formed bone. 2 years post-operatively no recurrence of infection had occurred. Note: See STIMULAN page for regulatory statements. MA0155R2
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