Purulent Sterile Wound Discharge Associated with Antibiotic Loaded Calcium Sulphate Beads: A Materiovigilance Case Report

Background: Antibiotic loaded calcium sulphate (CS) beads are emerging biomaterials used to provide sustained local antibiotic delivery in orthopaedic surgery. However, their use has been associated with wound discharge, which is purulent, serous, or serosanguineous in nature, although they are generally well tolerated. Case presentation: A woman approximately 50 years of age underwent implantation of gentamicin and vancomycin loaded calcium sulphate (CS) beads for the management of chronic osteomyelitis. Subsequently, she developed purulent wound discharge, which resolved following removal of the beads. Microbiological examination revealed no pathogens, acid-fast bacilli were not detected, and inflammatory cells were present. Conclusion: Clinicians should be aware of wound discharge associated with calcium sulphate beads and ensure appropriate postoperative monitoring. Further studies are needed to clarify the mechanism of culture-negative purulent wound discharge. This case underscores the importance of reporting orthopaedic implant-related adverse events to the Materiovigilance Programme of India (MvPI).