This study describes a new model of biofilm study in rabbits. The primary focus of this study was to assess biofilm adhesion to orthopaedic metals in their first 48 h in a femoral intramedullary implantation model. Two previous inoculation methods i.e. that of pre-and direct inoculation were studied with two bacterial isolates namely Staphylococcus uureus and epidermidis, on titanium and stainless steel metallic implants. A method of sonication and log dilution/plating was used to assess biofilm bacteria adhering to implants. Silver coated metals were then compared with their respective control metals in the new model. The direct inoculation model gave larger and more reproducible biofilm adhesion to implanted metals. Staphylococcus epidermidis shows lower adhesion ability to metals, and biofilms adhere in greater numbers to stainless steel over titanium.Silver coated metals show no statistical difference over control metals when exposed to orthopaedic biofilms.

All health care personnel, especially those in the rehabilitation field, are quite familiar with the frustrations that ischemic skin ulcers engender, particularly decubiti. When preventive measures prove unsuccessful, one is faced with the problem of enhancing tissue repair of the resultant lesion. A satisfactory method for the treatment of these lesions has eluded physicians for centuries, and the variety of therapeutic techniques is exceeded only by the number of resistant ulcers.Ischemic ulcers are, by definition, areas of chronic dermal and epidermal erosion in which local hypoxia plays a major role. Aggravating factors include a multitude of pathophysiologic processes; however, most of these ulcers are sequelae of chronic venous stasis with lower extremity varicosities, peripheral arterial insufficiency, or destructive forces that act on decentralized, denervated, or even normally innervated tissue.In the past, these lesions have responded most consistently to avoidance of pressure, cleanliness, and patience. A welcome break in this routine was described by Kanof' who reported the accelerating effect of ordinary gold leaf upon the healing of decubitus ulcers. Although the study was of limited scope, in terms of ulcer type and number of patients, the inherent potential of this unique regimen seemed to warrant further evaluation and investigation.Our evaluation of the gold leaf treatment* indicated a significant acceleration in healing rate. Of particular interest was the electrometric evidence that dissipation of the negative charge from the leaf was complete in about 48 hr and also that infected ulcers were aggravated by the negatively charged gold foil. It was hypothesized that the external application of a negatively charged substance (e.g., gold leaf) forms a dipole configuration with the adjacent tissue, whose polarity thereby becomes relatively more positive and catalyzes anabolism.Armed with this hypothesis, we next evaluated healing with applied direct constant current of known intensity by means of a constant-current generator with an output range of 200-1000 PA. The treatment regimen, which utilized lowintensity direct current (LIDC), produced a healing response clearly superior to that achieved with gold leaf. Subsequent refinement of the treatment protocol has resulted in a substantial improvement in healing rate over our initial results.We were surprised to find that the effects of polarity were the opposite to those

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