With more than 50% of bacteria resistant to standard antibiotics, new strategies to treat bacterial infection and colonization are needed. Based on the concept of targeting the bacteria synergistically on various fronts, it is hypothesized that an electrical insult associated with antibacterial materials may be a highly effective means of killing bacteria. In this work, an injectable conductive gel based on silk fibroin (SF) and silver nanoparticles (Ag‐NPs) is synthesized, capable of coating a zone of injury, allowing the application of a low electrical current to decrease bacterial contamination. With a high conductivity of 1.5 S cm−1, SF/Ag‐NPs gels killed 80% of Escherichia coli in 1 min, no toxicity toward Chinese hamster ovary cells is observed. The mechanism of an electrical composite gel combined with electrical wound therapy is associated with silver ion (Ag+) release, and reactive oxygen species (ROS) production. The findings in the present study show a similar Ag+ release for treatment with gels and the combined effect, whereas ROS generation is 50% higher when a small electrical current is applied leading to a broad bactericidal effect.
Health monitoring and screening have entered a period of rapid change. Popular terminology refers to this as mobile health (mHealth), which is a direct evolution of eHealth, but is really data‐driven technology—sensors oriented for health care. Medical decision support through this technology is the first step towards more personalized and preventative medicine. Pressure is one of the easiest and most interesting physiological parameters to assess whether organs or biological systems are healthy in the body. Pressure recordings are commonly used for clinical diagnosis and monitoring; however, the invasiveness of current technologies and associated risks of infection limit the windows in which data can be gathered. This review discusses the importance of pressure in the body and how monitoring is performed. It also describes newer and commercially available sensors, as well as how they can be improved to become minimally invasive, fully wireless pressure sensors for continuous monitoring.
Background:Acute compartment syndrome of the foot is a controversial topic. Release of the foot has been seen as complicated because of large incisions and postoperative morbidity, and there has been debate over whether this procedure is actually effective for releasing all areas of increased pressure. New sensor technology affords the opportunity to advance our understanding of acute compartment syndrome of the foot and its treatment. The purpose of the present study was to determine whether percutaneous decompression could be performed for the treatment of compartment syndrome in a forefoot model.Methods:The present study utilized a validated continuous pressure sensor to model compartment syndrome in human cadaveric feet. We utilized a pressure-controlled saline solution infusion system to induce increased pressure. A novel percutaneous release of the forefoot was investigated to assess its efficacy in achieving decompression.Results:For all cadaveric specimens, continuous pressure monitoring was accomplished with use of a continuous pressure sensor. There were 4 discrete compartment areas that could be reliably pressurized in all feet. The average baseline, pressurized, and post-release pressures (and standard deviations) were 4.5 ± 2.9, 43.8 ± 7.7, and 9.5 ± 3.6 mm Hg, respectively. Percutaneous decompression produced a significant decrease in pressure in all 4 compartments (p < 0.05).Conclusions:With use of continuous compartment pressure monitoring, 4 consistent areas were established as discrete compartments in the foot. All 4 compartments were pressurized with a standard pump system. With use of 2 small dorsal incisions, all 4 compartments were successfully released, with no injuries identified in the cutaneous nerve branches, extensor tendons, or arteries. These results have strong implications for the future of modeling compartment syndrome as well as for guiding clinical studies.Clinical Relevance:A reproducible and accurate method of continuous pressure monitoring of foot compartments after trauma is needed (1) to reliably identify patients who are likely to benefit from compartment release and (2) to help avoid missed or evolving cases of acute compartment syndrome. In addition, a reproducible method for percutaneous compartment release that minimizes collateral structural damage and the need for secondary surgical procedures is needed.
Surgical site infections (SSIs) account for a massive economic, physiological, and psychological burden on patients and health care providers. Sutures provide a surface to which bacteria can adhere, proliferate, and promote SSIs. Current methods for fighting SSIs involve the use of sutures coated with common antibiotics (triclosan). Unfortunately, these antibiotics have been rendered ineffective due to the increasing rate of antibiotic resistance. A promising new avenue involves the use of metallic nanoparticles (MNPs). MNPs exhibit low cytotoxicity and a strong propensity for killing bacteria while evading the typical antibiotic resistance mechanisms. In this work, we developed a novel MNPs dip-coating method for PDS-II sutures and explored the capabilities of a variety of MNPs in killing bacteria while retaining the cytocompatibility. Our findings indicated that our technique provided a homogeneous coating for PDS-II sutures, maintaining the strength, structural integrity, and degradability. The MNP coatings possess strong in vitro antibacterial properties against P aeruginosa and S. aureus—varying the %of dead bacteria from ~ 40% (for MgO NPs) to ~ 90% (for Fe2O3) compared to ~ 15% for uncoated PDS-II suture, after 7 days. All sutures demonstrated minimal cytotoxicity (cell viability > 70%) reinforcing the movement towards the use MNPs as a viable antibacterial technology.
Surgical site infections (SSIs) account for a massive economic, temporal, physiological, and psychological burden on patients and health care providers. It has been shown that sutures provide a surface to which bacteria can adhere, proliferate, and promote SSIs. Current methods for fighting postoperative SSIs involve the use of sutures coated with common antibiotics such as chlorohexidine or triclosan. Unfortunately, these antibiotics have been rendered ineffective in many cases due to the increasing rate of antibiotic resistance. A promising new avenue involves the use of metallic nanoparticles (NPs). Metallic NPs have been shown to exhibit low cytotoxicity and a strong propensity for killing bacteria while evading the typical antibiotic resistance mechanisms. In this work, we developed a novel metallic NPs dip-coating method for PDS-II sutures and explored the capabilities of a wide variety of metallic NPs coatings in killing bacteria while retaining the cytocompatibility of the suture. Our findings indicated that our non-toxic technique provided a homogeneous and well coating methodology for PDS-II sutures with a wide variety of metallic NP while maintaining the strength, structural integrity, and degradability of the suture. Excitingly, the metallic NP coatings possess strong in vitro antibacterial properties against P aeruginosa and S. aureus – varying the percentage of dead bacteria from ~ 40% (for MgO NPs) to ~ 95% (for Fe2O3) compared to ~ 15% for uncoated PDS-II suture, after 7 days. All sutures demonstrated minimal cytotoxicity (cell viability > 70%) reinforcing the movement towards the use metallic NPs as a viable antibacterial technology. PDS II sutures were successfully coated by an easy and non-toxic dip-coating method using a variety of metallic nanoparticles, proving to be a promising new avenue of research to fight surgical site infections.
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