EVs are the active component of the paracrine secretion by human CPCs. As a cell-free approach, EVs could circumvent many of the limitations of cell transplantation.
The C-Port System allows for a rapid, reliable, and compliant distal anastomosis and yields favorable 6-month angiographic and 12-month clinical results when compared with published studies.
To increase the efficacy of perioperative antibiotic prophylaxis in vascular surgery an experimental study including topical application ofthe gentamicin derivative EMD 46/217 and fibrin sealant as antibiotic carrier to Dacron prostheses was initiated. In vitro treatment ofDacron with gentamicin and fibrin was followed by constant antibiotic release for 3 weeks. In a subsequent animal study Dacron grafts were implanted in the aorta of 10 pigs after direct contamination with Staphylococcus .'Ureus solution. One graft was pretreated with the antibiotic/fibrin compound, a second with the antibiotic alone. Grafts 3 (no pretreatment) and 4 (fibrin alone) served as controls. After 1 week the grafts and their corresponding implantation sites were excised for measurement ofantibiotic content and for culture. The antibiotic content of grafts with the antibiotic/fibrin compound was 25.0 ± 7.2 p.g/gm wet weight, whereas Dacron pretreated with the antibiotic alone contained no measurable drug amounts except for one specimen (0.5 p.g/gm) (antibiotic/fibrin vs antibiotic, p < .0005). The corresponding implantation sites to antibiotic/fibrin grafts contained 1.07 ± 0.54 flog/gm antibiotic, whereas in only 2/10 implantation sites of antibiotic grafts low antibiotic levels were found (0.05 and 0.2 p.g/gm) (antibiotic/fibrin vs antibiotic,p < 0.005). All control grafts and 9/10 antibiotic grafts were infected. By contrast, only five were contaminated, and 5 of10 remained sterile after culture (antibiotic/fibrin vs antibiotic, p < 0.05). This finding correlates with the antibiotic content in the Dacron. It is concluded that pretreatment of prosthetic Dacron grafts with the antibiotic/fibrin compound results in binding of sufficient amounts of antibiotic for at least 1 week. This procedure can serve as a prophylactic tool against perioperative vascular graft infection.
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