Biodegradable rifampicin-releasing coating of surgical meshes for the prevention of bacterial infections

Abstract

Polypropylene mesh implants are routinely used to repair abdominal wall defects or incisional hernia. However, complications associated with mesh implantation, such as mesh-related infections, can cause serious problems and may require complete surgical removal. Hence, the aim of the present study was the development of a safe and efficient coating to reduce postoperative mesh infections. Biodegradable poly(lactide-co-glycolide acid) microspheres loaded with rifampicin as an antibacterial agent were prepared through single emulsion evaporation method. The particle size distribution (67.93±3.39 μm for rifampicin-loaded microspheres and 64.43±3.61 μm for unloaded microspheres) was measured by laser diffraction. Furthermore, the encapsulation efficiency of rifampicin (61.5%±2.58%) was detected via ultraviolet–visible (UV/Vis) spectroscopy. The drug release of rifampicin-loaded microspheres was detected by UV/Vis spectroscopy over a period of 60 days. After 60 days, 92.40%±3.54% of the encapsulated rifampicin has been continuously released. The viability of BJ fibroblasts after incubation with unloaded and rifampicin-loaded microspheres was investigated using an MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, which showed no adverse effects on the cells. Furthermore, the antibacterial impact of rifampicin-loaded microspheres and mesh implants, coated with the antibacterial microspheres, was investigated using an agar diffusion model with Staphylococcus aureus. The coated mesh implants were also tested in an in vivo mouse model of staphylococcal infection and resulted in a 100% protection against mesh implant infections or biofilm formation shown by macroscopic imaging, scanning electron microscopy, and histological examinations. This effective antibacterial mesh coating combining the benefit of a controlled drug delivery system and a potent antibacterial agent possesses the ability to significantly reduce postoperative implant infections.

Preparation, in vitro release and antibacterial activity evaluation of rifampicin and moxifloxacin-loaded poly(D,L-lactide-co-glycolide) microspheres

“…PLGA has good biocompatibility and controllable degradation rate and is widely used in biomedical engineering. It is also widely studied as a sustained-release carrier for local antibiotics for treating osteomyelitis [28,29]. However, the coloading of two antibiotics into PLGA microspheres which can increase the antimicrobial spectrum and improve its antimicrobial properties has rarely been studied.…”

Biological Scaffolds for Abdominal Wall Repair: Future in Clinical Application?

“…In a study of the improvement of synthetic meshes, Reinbold et al loaded polypropylene mesh with degradable poly (lactide-co-glycolide acid) microspheres carrying rifampicin, which is an antibacterial agent. The microspheres released rifampicin over 60 days and allowed for complete protection against S. Aureus in vivo [59]. This strategy could lead the way to develop unlimited loading combinations with not only antibiotics but also growth factors and cytokines in order to guide stem cell recruitment, tissue remodeling, and the inflammatory response.…”

Topical rifampicin for prevention of deep sternal wound infections in patients undergoing coronary artery bypass grafting

“…Other relevant features include: unexpensiveness and easiness of preparation and and handling. It has also been consistently shown to decrease wound infection in other surgical settings 4,7,22 . The present study is the first large scale trial to evaluate its preventive potential.…”