A versatile model of open-fracture infection

Penn-Barwell, Jowan G.; Rand, B.; Brown, Katherine E.; Wenke, Joseph C.

doi:10.1302/2046-3758.36.2000293

Cited by 24 publications

(8 citation statements)

References 13 publications

(14 reference statements)

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“…We were able to establish a hematogenously acquired infection on a metallic implant when at least 10 7 CFU of S. aureus was injected via a tail vessel. We saw a dose dependent effect when increasing the number of bacteria injected from 10 4 to 10 7 , similar to an effect noted by our laboratory when the bacteria was introduced locally [ 18 ]. The number of bacteria inoculated, either directly or hematogenously, relates directly to the ability of the bone to become infected.…”

Section: Discussionsupporting

confidence: 81%

Development of a hematogenous implant-related infection in a rat model

Shiels

Bedigrew

Wenke

2015

BMC Musculoskelet Disord

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BackgroundImplant-related osteomyelitis is a major complication that requires immediate treatment, often involving removal of the implant, prolonging patient recovery and inflating expenses. Current research involving interventions to diminish the prevalence of such measures include investigating prophylactic and therapeutic remedies. A proper and accurate animal model is needed to thoroughly investigate such treatments. The scope of this project was to develop an animal model in which a consistent and measurable infection can be formed on an orthopedic implant when bacteria is introduced via a hematogenous source.MethodsTitanium Kirschner-wires were implanted into the intramedullary canals of both femurs. Staphylococcus aureus, ranging from104 to 109 colony forming units, was injected into a tail vessel. After a designated time (3, 7, 14, or 42 days) the femurs were harvested and bacterial numbers determined for both the femur and the implanted K-wire. In addition, histology and micro-computed tomography were used as subjective tools to further characterize the infection.ResultsConsistent infection, that is infection of ≥75 % of the femurs, wasn’t achieved until 107 CFU S. aureus was injected. At 107 CFU, the femurs contained 4.6x106 CFU/g bone tissue at day 3 and 4.8×108 CFU/g bone tissue by day 14. The wire showed comparable contamination with 4.8×104 CFU/mm2 at day 3 and 3.7×105/mm2 by day 14. After 42 days, the bacteria number decreased but was still occupying at 1.9×105 CFU/g bone tissue. There were morphological changes to the bone as well. At day 42, there were signs of osteonecrosis and active bone formation when compared to control animals that received a K-wire but were inoculated with saline.ConclusionsA model for hematogenous osteomyelitis, a common complication associated with implants, has been introduced. A reproducible, preclinical model is essential to evaluate future methods used to mitigate blood-borne bacteria hardware and bone infections.

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Section: Discussionsupporting

confidence: 81%

Development of a hematogenous implant-related infection in a rat model

Shiels

Bedigrew

Wenke

2015

BMC Musculoskelet Disord

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“…These findings corroborate the study by Greenberg et al that described rates of 60% of remaining infection after ciprofloxacin systemic treatment for Staphylococcus aureus osteomyelitis. Similar findings were also encountered in animal models studies by Paiva Costa et al 26 , and Penn-Barwell et al 27 that encountered no infection control after systemic ciprofloxacin as an isolated treatment for osseous Staphylococcus aureus infection in rats.…”

Section: ■ Discussionsupporting

confidence: 79%

Prevention of bone infection after open fracture using a chitosan with ciprofloxacin implant in animal model

et al. 2020

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To evaluate different concentrations of ciprofloxacin to prevent infection after open fracture contaminated with S. aureus in rats using absorbable local delivery system. Methods: Fifty-two Wistar rats were assigned to six groups. After 4 weeks, all animals underwent 99mTc-ceftizoxima scintigraphy evaluation, callus formation measurement and histological analysis. ANOVA, t-Student and Kruskal Wallis were used for quantitative variables statistical analysis, whereas qui square and exact Fisher were used for qualitative variables. Results: Treatment using 25% and 50% of ciprofloxacin incorporated at the fracture fixation device were effective in preventing bone infection compared to control group (p<0.05). Chitosan were not effective in preventing bone infection when used alone compared to control group (p>0.05). Histological findings demonstrated bone-healing delay with 50% of ciprofloxacin. No difference in callus formation were observed (p>0.05). Conclusion: Local delivery treatment for contaminated open fracture using chitosan with ciprofloxacin is effective above 25%.

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“…A versatile model of open-fracture infection has been successfully built in animals. 16 Bacteria within a biofilm are protected against the killing action of antibiotics and the body’s immune system. 12 Bacteria can also enter osteoblasts and fibroblasts by some mechanism which is not yet fully understood.…”

Section: Discussionmentioning

confidence: 99%

Induced membrane technique for the treatment of bone defects due to post-traumatic osteomyelitis

Wang

Luo

Huang

et al. 2016

Bone & Joint Research

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ObjectivesInduced membrane technique is a relatively new technique in the reconstruction of large bone defects. It involves the implantation of polymethylmethacrylate (PMMA) cement in the bone defects to induce the formation of membranes after radical debridement and reconstruction of bone defects using an autologous cancellous bone graft in a span of four to eight weeks. The purpose of this study was to explore the clinical outcomes of the induced membrane technique for the treatment of post-traumatic osteomyelitis in 32 patients.MethodsA total of 32 cases of post-traumatic osteomyelitis were admitted to our department between August 2011 and October 2012. This retrospective study included 22 men and ten women, with a mean age of 40 years (19 to 70). Within this group there were 20 tibias and 12 femurs with a mean defect of 5 cm (1.5 to 12.5). Antibiotic-loaded PMMA cement was inserted into the defects after radical debridement. After approximately eight weeks, the defects were implanted with bone graft.ResultsThe patients were followed for 27.5 months (24 to 32). Radiographic bone union occurred at six months for 26 cases (81%) and clinical healing occurred in 29 cases (90%) at ten months. A total of six cases had a second debridement before bone grafting because of recurrence of infection and one patient required a third debridement. No cases of osteomyelitis had recurred at the time of the last follow-up visit.ConclusionThe induced membrane technique for the treatment of post-traumatic osteomyelitis is a simple, reliable method, with good early results. However, there are many challenges in determining the scope of the debridement, type of limb fixation and source of bone graft to be used.Cite this article: Dr Z. Xie. Induced membrane technique for the treatment of bone defects due to post-traumatic osteomyelitis. Bone Joint Res 2016;5:101–105. DOI: 10.1302/2046-3758.53.2000487.

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A versatile model of open-fracture infection

Cited by 24 publications

References 13 publications

Development of a hematogenous implant-related infection in a rat model

Development of a hematogenous implant-related infection in a rat model

Prevention of bone infection after open fracture using a chitosan with ciprofloxacin implant in animal model

Induced membrane technique for the treatment of bone defects due to post-traumatic osteomyelitis

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