Antibiotic-laden PMMA bead chains for the prevention of infection in compound fractures: current state of the art.

Antibiotic-laden PMMA bead chains are a valuable method of local antibiotic treatment in the prevention of infection in open fractures. When used in this setting, they provide high concentrations of broad-spectrum antibiotics to the area of the highest risk which may not be well perfused or reached by systemic antibiotics, while also eliminating dead space. In this article, the historical and current state of antibiotic-laden bead chains is discussed. The literature provides evidence that antibiotic-laden bead chains are a useful adjuvant with systemic antibiotics in the prevention of infection in open fractures. These bead chains can be sterilely prepared in the operating room or manufactured, and they maintain their elution and antimicrobial properties for a considerable time period. The bead chains also allow a high local concentration of antibiotics without risk of systemic toxicity or fear of clinically significant growth or persistence of bacteria on the beads. Bead chains are a practical method of local antibiotic therapy when the wounds can be closed.