The role of intraoperative antibiotic irrigation and postoperative antibiotic therapy for contaminated implantable prosthesis: in a rat model in vivo

Acar, Ömer; Mutlu, Birsen; Cimen, Kadir; Mutlu, N; DEMİRTAŞ, Muhammed Ahmet; Çulha, Mustafa; Gökalp, Ayşe Sevim

doi:10.1038/sj.ijir.3900604

Cited by 5 publications

(4 citation statements)

References 12 publications

(17 reference statements)

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“…In the study, these rats also showed typical skin lesions and purulent scrotal discharge, indicating clinical infection due to S. epidermidis. 16 We did not observe such findings during the study in any groups.…”

Section: Discussionmentioning

confidence: 60%

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Prosthesis culture 6 months after implantation and the effect of haematogenous seeding in a rat model

et al. 2004

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The aim of this study was to investigate the role of haematogenous seeding in late prosthesis infection. In all, 45 male Wistar albino rats were divided into three equal groups. A small piece of silicone prosthesis was implanted into the scrotum of all rats under sterile condition and antibiotic prophylaxis. In the first group, all silicones were removed after 6 months without any complication and were cultured for bacterial growth. In the second group, a disc, which was saturated with Staphylococcus epidermidis, was inoculated subcutaneously in the legs of the rats in the 6th month, revealing a nodule formation 4-5 days after the inoculation and treated with an appropriate antibiotic after the nodule formation. In the third group, the same disc was inoculated, but all rats were treated immediately from the inoculation time onwards. The silicones of the second and third group were also removed at the end of the 6th month and were cultured to observe the bacterial growth. There was no evidence of prosthesis infection in any of the three groups. In the first group, three cultures were positive and revealed approximately 10 000 colonies of S. epidermidis in two and Proteus mirabilis in the remaining. Three and four cultures were positive in the second and third group, respectively. Low colonies of four different organisms (Escherichia coli, S. aureus, S. epidermidis, Pseudomonas aeruginosa) were identified in these cultures. There was no statistical significance of positive cultures in the three groups. Based on our results, there does not appear to be a true significance of haematogenous seeding on late prosthesis infection.

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Section: Discussionmentioning

confidence: 60%

“…The rat model is apparently useful for investigating prosthesis infection and culture with respect to a similar study that was carried out before. 16,17 The aetiology of late prosthesis infection is still controversial. The effect of haematogenous seeding has been presented by many authors but not proven yet.…”

Section: Discussionmentioning

confidence: 99%

Prosthesis culture 6 months after implantation and the effect of haematogenous seeding in a rat model

et al. 2004

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“…Both injection and irrigation were found to reduce S . epidermidis growth over 20 days, ranging from 86.7% in the control group to 33.3% in the systemic treatment group and 13.3% in the irrigation treatment group ( 22 ). However, it is important to note that as appreciation of antibiotic stewardship evolves, recent clinical studies have argued against postoperative antibiotics unless particular risk factors are identified, as the benefits to their use are limited ( 23 ).…”

Section: Resultsmentioning

confidence: 99%

Addressing the need for preclinical study of penile prosthesis infection: a new animal model and narrative review

Shah,

Liu,

Machado

et al. 2024

Transl Androl Urol

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Background and Objective Erectile dysfunction (ED) is a common condition in men, and many patients refractory to conservative treatment may undergo penile prostheses (PPs) placement. The primary concern following PP implantation is device infection. Although antibiotic and hydrophilic coatings have reduced the incidence of inflatable PP (IPP) infections, there remains room for improvement. Optimization of PP outcomes requires a practical in vivo model to better understand mechanisms of infection and to test new infection control strategies. We aimed to describe a new rabbit model which contains a functional IPP and review previously reported animal PP models. Methods An IPP was placed into rabbit flanks and cycled for functionality testing. Rabbits were evaluated for signs of pain and distress over 14 days. Separately, narrative review methodology was utilized to search the PubMed and Scopus databases for all publications through March 21, 2023, which studied PP within an in vivo setting. Three independent reviewers ultimately selected 12 papers from 1992–2021 for inclusion. Key Content and Findings Several animal studies highlighted the initial functionality or feasibility of devices for ED before their introduction in the clinical setting. There are several subsequent studies aimed at optimizing the type of antibiotic use or coating material using segments of PP material in an in vivo setting. However, the literature lacks a contemporary animal model containing a functional IPP. Our novel rabbit model offers a safe, practical way to implant a functioning IPP and investigate new perioperative infection prevention and treatment strategies before trials in the clinical setting. Conclusions Animal models have played a key role in testing medical devices, including PPs, prior to their clinical introduction. Our review uncovered no modern animal studies involving placement of a functional PP. A new animal model can facilitate study of evolving microorganism profiles, novel methods to enhance antibiotic delivery, and proposed treatment options.

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“…The value of aggressive intraoperative antibiotic irrigation during savage of clinically infected penile prostheses has been shown clearly [17,18]. Studies also have demonstrated that infections in prostheses contaminated with Staphylococcus epidermidis can be nearly eliminated with the use of intraoperative device irrigation [30].…”

Section: Infection Preventionmentioning

confidence: 98%

Penile prosthesis coating and the reduction of postoperative infection

Abouassaly

Montague

2004

Curr Urol Rep

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Despite the recent development of effective oral agents for the treatment of erectile dysfunction, penile prosthesis implantation remains an effective and acceptable treatment for the significant number of men who fail to respond to nonsurgical therapy. The most serious complication that can affect the use of most prosthetic devices is infection. In penile prostheses, this can be devastating and frequently results in removal of the device despite aggressive antibiotic therapy. In recent years, new strategies have been developed in an attempt to minimize this risk. This review focuses on one such method, namely the use of an antibiotic coating on the device. It reviews recent published data regarding the effectiveness of such devices at decreasing infection rates.

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The role of intraoperative antibiotic irrigation and postoperative antibiotic therapy for contaminated implantable prosthesis: in a rat model in vivo

Cited by 5 publications

References 12 publications

Prosthesis culture 6 months after implantation and the effect of haematogenous seeding in a rat model

Prosthesis culture 6 months after implantation and the effect of haematogenous seeding in a rat model

Addressing the need for preclinical study of penile prosthesis infection: a new animal model and narrative review

Penile prosthesis coating and the reduction of postoperative infection

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