The use of antibiotic-impregnated fibrin sealant for the prevention of surgical site infection associated with spinal instrumentation

Tofuku, Katsuhiro; Koga, Hiroaki; Yanase, Mitsuhiro; Komiya, Setsuro

doi:10.1007/s00586-012-2435-4

Cited by 32 publications

(26 citation statements)

References 23 publications

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“…aureus contaminated rat model of titanium spine clip implantation [292]. The second paper found similar results suggesting a benefit to combining vancomycin with fibrin sealant on in-vitro agar plates [293]. The investigators also performed a sequential clinical study comparing surgically placed orthopedic hardware without ( n = 188, 2003–2007) and with ( n = 196, 2007–2010) local application of the antibiotic impregnated fibrin sealant and found significant reductions in the rates of surgical site infection in the antibiotic fibrin sealant hardware group (0/196, 0% versus 11/188, 5.8%, P = 0.0003) [293].…”

Section: Less Frequently Published Clinical Applications Of Fibrinmentioning

confidence: 92%

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

2014

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Background. Fibrin sealant became the first modern era material approved as a hemostat in the United States in 1998. It is the only agent presently approved as a hemostat, sealant, and adhesive by the Food and Drug Administration (FDA). The product is now supplied as patches in addition to the original liquid formulations. Both laboratory and clinical uses of fibrin sealant continue to grow. The new literature on this material also continues to proliferate rapidly (approximately 200 papers/year). Methods. An overview of current fibrin sealant products and their approved uses and a comprehensive PubMed based review of the recent literature (February 2012, through March 2013) on the laboratory and clinical use of fibrin sealant are provided. Product information is organized into sections based on a classification system for commercially available materials. Publications are presented in sections based on both laboratory research and clinical topics are listed in order of decreasing frequency. Results. Fibrin sealant remains useful hemostat, sealant, and adhesive. New formulations and applications continue to be developed. Conclusions. This agent remains clinically important with the recent introduction of new commercially available products. Fibrin sealant has multiple new uses that should result in further improvements in patient care.

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Section: Less Frequently Published Clinical Applications Of Fibrinmentioning

confidence: 92%

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

2014

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“…Considering the natural presence of fibrin in the healing process, fibrin is employed by surgeons as a sealant for general wound hemostasis. Fibrin sealants have also been utilized for infection prophylaxis by adding powdered antibiotic to the polymerizing fibrin gel at the site of wound closure [131]. …”

Section: Experimental Biomaterials For Local Antibiotic Deliverymentioning

confidence: 99%

Biomaterials approaches to treating implant-associated osteomyelitis

et al. 2016

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Orthopaedic devices are the most common surgical devices associated with implant-related infections and Staphylococcus aureus (S. aureus) is the most common causative pathogen in chronic bone infections (osteomyelitis). Treatment of these chronic bone infections often involves combinations of antibiotics given systemically and locally to the affected site via a biomaterial spacer. The gold standard biomaterial for local antibiotic delivery against osteomyelitis, poly(methyl methacrylate) (PMMA) bone cement, bears many limitations. Such shortcomings include limited antibiotic release, incompatibility with many antimicrobial agents, and the need for follow-up surgeries to remove the non-biodegradable cement before surgical reconstruction of the lost bone. Therefore, extensive research pursuits are targeting alternative, biodegradable materials to replace PMMA in osteomyelitis applications. Herein, we provide an overview of the primary clinical treatment strategies and emerging biodegradable materials that may be employed for management of implant-related osteomyelitis. We performed a systematic review of experimental biomaterials systems that have been evaluated for treating established S. aureus osteomyelitis in an animal model. Many experimental biomaterials were not decisively more efficacious for infection management than PMMA when delivering the same antibiotic. However, alternative biomaterials have reduced the number of follow-up surgeries, enhanced the antimicrobial efficacy by delivering agents that are incompatible with PMMA, and regenerated bone in an infected defect. Understanding the advantages, limitations, and potential for clinical translation of each biomaterial, along with the conditions under which it was evaluated (e.g. animal model), is critical for surgeons and researchers to navigate the plethora of options for local antibiotic delivery.

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“…Tofuku et al reported that the use of an antibiotic-impregnated fibrin sealant (AFS) significantly reduced the rates of deep surgical site infections (SSIs) in patients who underwent implantation of orthopedic hardware surgery; 11 of the 188 patients acquired a deep SSI in the group treated without AFS while none of the 196 patients acquired a deep SSI in the other group. 181 Another research area is the treatment of bone defects that suffer from infection. Co-delivery of antibiotic and osteogenic cells via a fibrin scaffold may be an ideal option.…”

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confidence: 99%

A review of fibrin and fibrin composites for bone tissue engineering

Noori

Ashrafi

Vaez-Ghaemi

et al. 2017

IJN

368

256

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Tissue engineering has emerged as a new treatment approach for bone repair and regeneration seeking to address limitations associated with current therapies, such as autologous bone grafting. While many bone tissue engineering approaches have traditionally focused on synthetic materials (such as polymers or hydrogels), there has been a lot of excitement surrounding the use of natural materials due to their biologically inspired properties. Fibrin is a natural scaffold formed following tissue injury that initiates hemostasis and provides the initial matrix useful for cell adhesion, migration, proliferation, and differentiation. Fibrin has captured the interest of bone tissue engineers due to its excellent biocompatibility, controllable biodegradability, and ability to deliver cells and biomolecules. Fibrin is particularly appealing because its precursors, fibrinogen, and thrombin, which can be derived from the patient’s own blood, enable the fabrication of completely autologous scaffolds. In this article, we highlight the unique properties of fibrin as a scaffolding material to treat bone defects. Moreover, we emphasize its role in bone tissue engineering nanocomposites where approaches further emulate the natural nanostructured features of bone when using fibrin and other nanomaterials. We also review the preparation methods of fibrin glue and then discuss a wide range of fibrin applications in bone tissue engineering. These include the delivery of cells and/or biomolecules to a defect site, distributing cells, and/or growth factors throughout other pre-formed scaffolds and enhancing the physical as well as biological properties of other biomaterials. Thoughts on the future direction of fibrin research for bone tissue engineering are also presented. In the future, the development of fibrin precursors as recombinant proteins will solve problems associated with using multiple or single-donor fibrin glue, and the combination of nanomaterials that allow for the incorporation of biomolecules with fibrin will significantly improve the efficacy of fibrin for numerous bone tissue engineering applications.

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The use of antibiotic-impregnated fibrin sealant for the prevention of surgical site infection associated with spinal instrumentation

Cited by 32 publications

References 23 publications

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

Biomaterials approaches to treating implant-associated osteomyelitis

A review of fibrin and fibrin composites for bone tissue engineering

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