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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Hauptverfasser: Boot, Willemijn (VerfasserIn) , Vogely, H. C. (VerfasserIn) , Nikkels, P. G. J. (VerfasserIn) , Pouran, B. (VerfasserIn) , van Rijen, M. H. P. (VerfasserIn) , Ekkelenkamp, M. B. (VerfasserIn) , Hänsch, Gertrud Maria (VerfasserIn) , Dhert, W. J. A. (VerfasserIn) , Gawlitta, D. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: February 19, 2020
In: European cells & materials
Year: 2020, Jahrgang: 39, Pages: 108-120
ISSN:1473-2262
DOI:10.22203/eCM.v039a07
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.22203/eCM.v039a07
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Verfasserangaben: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

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520 |a 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. 
650 4 |a antibiotic-resistance 
650 4 |a bioactive glass 
650 4 |a bone 
650 4 |a cement 
650 4 |a chronic osteomyelitis 
650 4 |a hydrogel 
650 4 |a Implant-related infection 
650 4 |a in vivo 
650 4 |a in-vitro 
650 4 |a local delivery 
650 4 |a prevention 
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650 4 |a replacement 
650 4 |a titanium implants 
650 4 |a total hip-arthroplasty 
650 4 |a vancomycin 
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700 1 |a Gawlitta, D.  |e VerfasserIn  |4 aut 
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