Antibiotic-Releasing Mesh Coating to Reduce Prosthetic Sepsis: An In Vivo Study

Harth, Karem C.; Rosen, Michael J.; Thatiparti, Thimma R.; Jacobs, Michael; Halaweish, Ihab; Bajaksouzian, Saralee; Furlan, Joseph; Recum, Horst A. von

doi:10.1016/j.jss.2010.03.065

Cited by 64 publications

(86 citation statements)

References 29 publications

(33 reference statements)

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“…A bolus antibiotic injection serves to eradicate the planktonic bacteria surrounding the initial infection, while the implanted affinity polymer serves as an antibiotic depot slowly re-administer drug to eradicate the less metabolically active bacteria that are present in biofilm. Affinity polymer filled with vancomycin prior to implantation has already been shown to prevent device infection in rodents [41,42] and has also prevented Methicillin-resistant S. aureus (MRSA) hernia defect infection in pigs (manuscript submitted). The versatility of affinity polymers makes them amenable for use in both hard and soft tissue applications.…”

Section: Discussionmentioning

confidence: 99%

Affinity interactions drive post-implantation drug filling, even in the presence of bacterial biofilm

Cyphert

Zuckerman²,

Korley³

et al. 2017

Acta Biomaterialia

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Current post-operative standard of care for surgical procedures, including device implantations, dictates prophylactic antimicrobial therapy, but a percentage of patients still develop infections. Systemic antimicrobial therapy needed to treat such infections can lead to downstream tissue toxicities and generate drug-resistant bacteria. To overcome issues associated with systemic drug administration, a polymer incorporating specific drug affinity has been developed with the potential to be filled or refilled with antimicrobials, post-implantation, even in the presence of bacterial biofilm. This polymer can be used as an implant coating or stand-alone drug delivery device, and can be translated to a variety of applications, such as implanted or indwelling medical devices, and/or surgical site infections. The filling of empty affinity-based drug delivery polymer was analyzed in an in vitro filling/refilling model mimicking post-implantation tissue conditions. Filling in the absence of bacteria was compared to filling in the presence of bacterial biofilms of varying maturity to demonstrate proof-of-concept necessary prior to in vivo experiments. Antibiotic filling into biofilm-coated affinity polymers was comparable to drug filling seen in same affinity polymers without biofilm demonstrating that affinity polymers retain ability to fill with antibiotic even in the presence of biofilm. Additionally, post-implantation filled antibiotics showed sustained bactericidal activity in a zone of inhibition assay demonstrating post-implantation capacity to deliver filled antibiotics in a timeframe necessary to eradicate bacteria in biofilms. This work shows affinity polymers can fill high levels of antibiotics post-implantation independent of biofilm presence potentially enabling device rescue, rather than removal, in case of infection.

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Section: Discussionmentioning

confidence: 99%

Affinity interactions drive post-implantation drug filling, even in the presence of bacterial biofilm

Cyphert

Zuckerman²,

Korley³

et al. 2017

Acta Biomaterialia

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“…Afterwards, the mesh was implanted subcutaneously in dorsum of rats with S. aureus inoculation. The results of the study showed that the drug delivery continued up to 4 weeks without signs of infection [84].…”

Section: Nanotechnologymentioning

confidence: 94%

“…It should be non-toxic and absorbable. Moreover, the coating should change neither tissue integration, wound healing nor biochemical properties of the mesh [84].…”

Section: Mesh Modificationsmentioning

confidence: 99%

Innovative Modifications for Preventing Mesh Infections

Aydınuraz¹

2017

J Microb Biochem Technol

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“…В хирургии одним из самых частых осложнений является развитие инфекции раны, которое может привести к развитию сепсиса в послеоперацион-ном периоде [2,19]. Для предотвращения этого осложнения существует множество способов, на-правленных на деконтаминацию патогенных и ус-ловно-патогенных микроорганизмов, в том числе применение антимикробных препаратов до опера-тивного вмешательства.…”

Section: вве дениеunclassified

Choise of local antibacterial medications for prevention of sternal infection

et al. 2017

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Infection of wounds in surgery is one of the most frequent complications in the postoperative period. The development of this complication increases the duration of hospitalization, resulting in higher treatment costs, as well as the impact to the level of hospital mortality. There are many methods are exist to avoid this complication, which are allow to decontamination of pathogenic and conditionally pathogenic microorganisms including applying antimicrobial agents prior to surgery. One such method is intravenous antibiotic shortly before surgery. But there is evidence in the literature of successful local antibiotics in neurosurgery, traumatology and orthopedics, operations on the thorax and abdominal organs, including for prevention of sternal infection. For this purpose most often used vancomycin and gentamicin. This is often a causative agent of wound infection, which is a gram-positive flora: Staphylococcus aureus and Staphylococcus epidermidis. To increase the effectiveness of preventive measures to reduce the incidence of sternal infection intraoperatively topically applied antibiotics in various forms when closing the wound. For parenteral administration of antibiotics effective therapeutic dose is often not achieved, because it depend on the time period since the introduction of the substance until the start of the operation [3]. Local application of antibiotics to a reduction of frequency wound infection, as concentration of a substance is directly dependent on the applied dose.

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Antibiotic-Releasing Mesh Coating to Reduce Prosthetic Sepsis: An In Vivo Study

Cited by 64 publications

References 29 publications

Affinity interactions drive post-implantation drug filling, even in the presence of bacterial biofilm

Affinity interactions drive post-implantation drug filling, even in the presence of bacterial biofilm

Innovative Modifications for Preventing Mesh Infections

Choise of local antibacterial medications for prevention of sternal infection

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