antibiotic cement bead pouch

Antibiotic cement bead pouch is a wound management strategy in which non-absorbable beads made from polymethyl methacrylate (PMMA) bone cement are mixed with powdered antibiotics and placed into an open wound or dead space. The beads are then sealed within the wound using an occlusive dressing to create a "pouch." This technique delivers high local concentrations of antibiotics directly to the site of infection or contamination while minimizing systemic toxicity. The most commonly used antibiotics are vancomycin and aminoglycosides (such as gentamicin or tobramycin), chosen for their broad spectrum and heat stability during PMMA polymerization. The primary indications include management of open fractures, chronic osteomyelitis, infected joint prostheses, and other musculoskeletal infections where dead space needs to be filled and infection controlled. The mechanism involves local elution of antibiotics from the PMMA matrix over several days to weeks, preventing bacterial growth and biofilm formation in avascular areas that may not be reached by systemic therapy[1][3][4][5][6]. After the risk period has passed or definitive closure is possible, the non-absorbable beads must be surgically removed.

Other names

antibiotic bead pouchantibiotic-laden cement beadsantibiotic-impregnated cement beadsABP