Prophylaxis of implant-related infections by local release of vancomycin from a hydrogel in rabbits
Local prophylaxis with antibiotic-loaded bone cement is a successful method to prevent post-operative infections in patients receiving orthopaedic implants. No comparable method is available for uncemented implants. Therefore, a hydrogel consisting of hyaluronic and polylactic acids was evaluated in...
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| Main Authors: | , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
February 19, 2020
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| In: |
European cells & materials
Year: 2020, Volume: 39, Pages: 108-120 |
| ISSN: | 1473-2262 |
| DOI: | 10.22203/eCM.v039a07 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.22203/eCM.v039a07
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| Author Notes: | W. Boot, H.C. Vogely, P.G.J. Nikkels, B. Pouran, M.H.P. van Rijen, M.B. Ekkelenkamp, G.M. Haensch, W.J.A. Dhert, D. Gawlitta |
| Summary: | Local prophylaxis with antibiotic-loaded bone cement is a successful method to prevent post-operative infections in patients receiving orthopaedic implants. No comparable method is available for uncemented implants. Therefore, a hydrogel consisting of hyaluronic and polylactic acids was evaluated in a rabbit model for delivery of antimicrobial agents to prevent post-operative infections. In a pilot study, the suitability of the in vivo model was assessed by testing the hydrogel as carrier material for antimicrobial agents. In the main study, the antimicrobial-agent-loaded hydrogel was evaluated for infection prophylaxis. Rabbits received a titanium rod intramedullary in the tibia after contamination with Staphylococcus aureus. The rods were coated with unloaded hydrogel (Gel), hydrogel loaded with 2 % (Van2) or 5 % vancomycin (Van5), bioactive glass (BAG) or N-acetyl-L-cysteine (NAC). To analyse the infection severity after 28 d, histopathological, bacteriological, micro-computed tomographic and haematological analyses were performed. In the pilot study, the Van5 group had less infection (0/6 infected) as compared to the Gel group (5/5, p = 0.000) and the in vivo model was deemed suitable. In the main study, in the Van2 and Van5 groups, the number of infected animals was lower [1/6 (p = 0.006) and 2/6 (p = 0.044) infected, respectively]. In contrast, BAG and NAC groups showed no infection reduction (5/6 both groups, p = 0.997). The hydrogel can be used as a local carrier of vancomycin for prophylaxis of implant-related infections. The present study showed promising results for local delivery of antibacterial agents by hydrogel to prevent implant-related infections. |
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| Item Description: | Gesehen am 08.06.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1473-2262 |
| DOI: | 10.22203/eCM.v039a07 |