Wounded troops may get antibiotic beads

By Chris Amos - Staff writer
Posted : February 12, 2007

If all goes well, boxes of antibiotic beads that could save the lives and limbs of military personnel wounded in Iraq and Afghanistan will be on the battlefield by May.

The beads, small cement balls coated with powdered antibiotics and connected by a string, look and feel like pearl necklaces. They are placed inside wounds in the first hours after an injury and slowly release antibiotics into damaged tissues.

Navy Capt. Dana Covey, chairman of orthopedic surgery at Naval Medical Center San Diego, who has twice served with forward-deployed medical units in Iraq, said the beads would be a plus.

“When I go back to Iraq, I want something I can pull open and put in the wound before that helicopter takes them away,” he said.

Steven J. Keough, a retired Navy captain who is a general manager for SurModics, a Minneapolis-based health care products company, said the firm has applied for fast-track approval from the Food and Drug Administration to produce the beads for the Navy.

Keough said the company could have an answer by May. He declined to discuss what the Navy would be charged for the beads, but he said they would be competitively priced.

FDA officials were unavailable for comment Jan. 25.

The antibiotic effect of the beads lasts about three days, Keough said. After that, they are removed and can be replaced with new beads.

Antibiotic beads will be particularly important for combat medicine, Covey said, because many traumatic injuries in Iraq and Afghanistan are caused by powerful blasts that blow shrapnel, mud, animal waste, debris and sand deep into a wound normally much larger than a civilian traumatic wound.

Military doctors often don’t have the ability or the time to find and remove all the foreign matter, especially during mass-casualty events, Covey said.

As injured tissue inside the wound gradually dies, bacteria blown into the body feast on it; virulent infection can quickly set in.

“Dead tissue is food for bacteria,” Covey said.

Once they take root, infections can become chronic, Covey said, and eventually lead to loss of muscle tissue and limb function, amputations and even death.

“Some you can’t stop for months,” he said. “It has a direct effect on rehabilitation.”

Covey said that infection rates have climbed above 40 percent for combat orthopedic injuries in Iraq and Afghanistan. Infection rates for civilian traumatic injuries are normally less than 5 percent.

Antibiotic beads are not new; they have been used by civilian doctors for almost 30 years, but doctors have always made their own because they have never been commercially available.

Lt. Cmdr. Sonya Waters, an orthopedic surgery resident at National Naval Medical Center Bethesda, Md., and a Navy diver, said she finds herself making beads on operating-room tables as often as five times per week.

Ellie