Vascular graft infections: In vitro and in vivo investigations of a new vascular graft with long‐term protection

Abstract

We investigated a polyester vascular prosthesis (PET) coated with elemental silver (SC). Measurement of silver release over a period of 52 weeks by means of inductively coupled plasma atomic emission spectrometry of PET with (PET-G) and without (PET-N) gelatine impregnation revealed a silver release on the first day of 1.2 +/- 0.2 microg (PET-N) and 1.2 +/- 0.1 microg (PET-G) (calculated for 1 g of prosthesis); from the 90th day onward, it was between 0.22 +/- 0.14 microg (PET-N) and 0.18 +/- 0.12 microg (PET-G) per day. The prostheses were incubated with Staphylococcus aureus (S.a.), Staphylococcus epidermidis (S.e.), or Escherichia coli (E.c.) to investigate in vitro antibacterial efficacy. After 6 h of incubation, no colony-forming units were to be seen for any of the bacterial suspensions for PET with SC (p < 0.001). To investigate in vivo antibacterial efficacy, PET-G rings with and without SC contaminated with S.a., S.e., or E.c. were implanted in 18 albino rabbits and examined 7 days after agar culture for 48 h. The silver coating was associated with a significant reduction in bacterial growth (S.a., p = 0.001; S.e., p < 0.005; E.c., p < 0.001). The silver-coated prosthesis, with and without gelatine impregnation, had a significantly antibacterial effect with continuous release of silver.

Localized Argyria Caused by Metallic Silver Aortic Grafts: A Unique Adverse Effect

“…Toxic effects have not been reported from the B. Braun silver graft. 6 The elemental difference in how silver is bonded determines how both grafts can be used. The InterGard silver graft offers only a temporary antimicrobial activity for prophylactic use during the postoperative period.…”

Prevention of Early Vascular Graft Infection Using Regional Antibiotic Release

“…This aims to prevent the initial step of successful biofilm formation via adhesion of bacteria to the device, thereby allowing for host cell integration into the prosthesis, necessary for an uneventful healing process. Various methods have been reported to coat vascular prostheses with antimicrobial agents [7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Different antibiotics are used, sometimes combined with different carriers to ensure an extended release profile.…”

Prophylactic use of the silver-acetate–coated graft in arterial occlusive disease: A retrospective, comparative study

“…Whereas the silver degrades from the InterGard conduit within 4 weeks*, the Braun graft has a slower release, lasting for more than a year. 1 Silver prostheses are more expensive than their uncoated counterpart: according to list prices published by the manufacturer (Intervascular), the silver-acetate-coated prosthesis costs 14-16% more than the uncoated implant.…”

“…[1][2][3] These studies, where the silveracetate-coated polyester prostheses performed less well than rifampin-soaked grafts, have been criticized. 4,5 The InterGard Silver prostheses were sterilized in an autoclave before being implanted in animals.…”