A rapid, flexible method for incorporating controlled antibiotic release into porous polymethylmethacrylate space maintainers for craniofacial reconstruction

Abstract

Severe injuries in the craniofacial complex, resulting from trauma or pathology, present several challenges to functional and aesthetic reconstruction. The anatomy and position of the craniofacial region make it vulnerable to injury and subsequent local infection due to external bacteria as well as those from neighboring structures like the sinuses, nasal passages, and mouth. Porous polymethylmethacrylate (PMMA) “space maintainers” have proven useful in staged craniofacial reconstruction by promoting healing of overlying soft tissue prior to reconstruction of craniofacial bones. We describe herein a method by which the porosity of a prefabricated porous PMMA space maintainer, generated by porogen leaching, can be loaded with a thermogelling copolymer-based drug delivery system. Porogen leaching, space maintainer prewetting, and thermogel loading all significantly affected the loading of a model antibiotic, colistin. Weeks-long release of antibiotic at clinically relevant levels was achieved with several formulations. In vitro assays confirmed that the released colistin maintained its antibiotic activity against several bacterial targets. Our results suggest that this method is a valuable tool in the development of novel therapeutic approaches for the treatment of severe complex, infected craniofacial injuries.

Polymer-augmented liposomes enhancing antibiotic delivery against intracellular infections

“…Building upon the findings of the current study, future design criteria for antibiotic carriers against intracellular infections may include differential release mechanisms that respond to the microenvironemnt of the intracellular infection setting (e.g., bacterial enzymes 60 ), or respond to physical stimuli (e.g, ultrasound) to minimize off-target release 61 . Additionally, antibiotic carriers that can provide sustained release at the site of infection are postulated to improve drug retention, and therefore potentially reduce dosing frequency 62 .…”

Salvage of Infected Prosthetic Breast Reconstructions

“…[24][25][26][27][28][29] Similar methods using PMMA beads have been used for additional orthopedic, vascular, and cardiothoracic surgery. 24,[30][31][32][33][34][35][36][37] Sterilization rates in the literature range from 60% to 100% with infection recurrence rates between 0 to 20%. 7,24,30,31,35 More recently, the use of antibiotic-impregnated PMMA beads in left ventricular assist device infections has resulted in a salvage rate of 65.4% with a recurrence rate of 17.6%.…”

Design of Novel Perovskite-Based Polymeric Poly(l-Lactide-Co-Glycolide) Nanofibers with Anti-Microbial Properties for Tissue Engineering

“…However, given its anti-microbial potential, efforts to reduce the toxicity of Ag-based biomaterials on human cells has continued [ 20 ], and several impressive material science strategies, such as reduction of nanoparticles size [ 21 ], have been applied. Application of biomaterial advances to control microbial growth through the release of anti-microbial agents such as Ag continues to be a prime area of research across many fields [ 22 , 23 , 24 ]. This study explores the use of anti-microbial perovskite materials containing Ag and hypothesizes that such materials might have the potential to limit cell toxicity but preserve the anti-microbial properties of wound dressing.…”