Measurement of the Silver Ion Concentration in Wound Fluids after Implantation of Silver-Coated Megaprostheses: Correlation with the Clinical Outcome

Abstract

Background. Tumor patients and patients after traumas are endangered by a reduced immune defense, and a silver coating on their megaprostheses may reduce their risks of infection. The aim of this study was to determine the silver ion concentration directly measured from the periprosthetic tissue and the influence on the clinical outcome. Material and Methods. Silver ions were evaluated in 5 mL wound fluids two days postoperatively and in blood patients 7 and 14 days after surgery using inductively coupled plasma emission spectrometry in 18 patients who underwent total joint replacement with a silver-coated megaendoprosthesis. Results. The concentration of silver ions averaged 0.08 parts per million. Patients who showed an increased silver concentration in the blood postoperatively presented a lower silver concentration in the wound fluids and a delayed decrease in C-reactive protein levels. There were significantly fewer reinfections and shorter hospitalization in comparison with a group that did not receive a silver-coated megaprosthesis. Conclusion. An increased concentration of silver in the immediate surroundings of silver-coated prostheses was demonstrated for the first time in cohorts of patients with trauma or tumors. An elevated concentration of silver ions in the direct periprosthetic tissue may have reduced the infection rate.

Bacterial adhesion on biomedical surfaces covered by yttria stabilized zirconia

“…It is true that silver-coated prostheses are 5-7 % more expensive than uncoated prostheses [31]. However, the significant decrease in the period of hospitalization and decreased revision surgeries should be factors to be taken into account when considering the cost-effectiveness of the changes to be implemented in the future relationship [32].…”

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“…Silver coated prosthesis, vancomycin coated prosthesis and iodine impregnated implants have all shown promise in early results. [16][17][18] Children, because of the dynamic nature of growing bones pose a unique challenge. The issue of ultimate limb length discrepancy at skeletal maturity also influences the choice of reconstruction, especially in the lower limb.…”

Can systemically administered antibiotics be detected in wound tissues and surfaces under negative pressure wound therapy?

“…In the past, several approaches were used to accomplish this, for example, microdilution, 3 equilibrium chamber, 4 and cantharis-induced or perioperative blisters after excisional surgery. [5][6][7] All these methods are either too expensive or too complex for use in the clinical routine.…”