Kilian Olaf, Hossain Hamid, Flesch Ingo, Sommer Ursula, Nolting Heiko, Chakraborty Trinad, Schnettler Reinhard
Department of Trauma Surgery, University of Giessen-Marburg, Giessen, Germany.
J Biomed Mater Res B Appl Biomater. 2009 Jul;90(1):210-22. doi: 10.1002/jbm.b.31275.
Management of bone and soft tissue infections generally includes surgical procedures as well as attendant treatment and prevention with gentamicin-loaded fleeces. Conventional gentamicin-containing collagen fleeces currently in use are strongly acidic and exhibit limited biocompatibility thereby adversely affecting wound healing. To improve the antibiotic delivery system, a new phosphate-buffered, gentamicin-loaded fleece with pH-neutral properties has been developed (Jason G). This study aimed at comparing the elution kinetics of gentamicin release and the antimicrobial efficacy of conventional fleeces with the newly developed fleece in vitro. In addition, degradation and microvasculature of implanted fleeces were examined in a rat model and assessed using histology, as well as detection of ED-1 and PECAM-expression using immunohistochemistry. We show that the phosphate-buffered fleeces have reduced release (p < 0.05) of the integrated gentamicin. However, all of the fleeces tested had a significant antimicrobial effect on the growth of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa strains (p < 0.01). Among the fleeces tested, the new Jason G fleece had the weakest but nevertheless sufficient antimicrobial effectiveness. Evaluation of the antibiotic effect in the prevention of an infection showed no differences between the applied fleeces. Following surgical implantation of fleece in the backs of Wistar rats we observed, on day 5 after implantation, an increase in cell infiltration and microvascularization with the phosphate-buffered fleece as compared with conventional fleeces, which show necrotic cells on their surface. Unlike the acidic fleeces, on day 15 after implantation the pH-neutral fleece was resorbed widely. Here, we show that the new, pH-neutral, gentamicin-containing fleece Jason G exhibits good overall antimicrobial effectiveness against both gram-positive and gram-negative bacteria in vitro with improved degradation properties and microvasculature formation in vivo.
骨与软组织感染的管理通常包括外科手术以及使用含庆大霉素的羊毛毡进行相应的治疗和预防。目前使用的传统含庆大霉素的胶原羊毛毡呈强酸性,生物相容性有限,从而对伤口愈合产生不利影响。为了改进抗生素递送系统,已开发出一种具有pH中性特性的新型磷酸盐缓冲含庆大霉素羊毛毡(Jason G)。本研究旨在比较庆大霉素释放的洗脱动力学以及传统羊毛毡与新开发羊毛毡在体外的抗菌效果。此外,在大鼠模型中检查植入羊毛毡的降解和微血管形成情况,并使用组织学以及通过免疫组织化学检测ED-1和PECAM表达进行评估。我们发现,磷酸盐缓冲羊毛毡中整合的庆大霉素释放量减少(p < 0.05)。然而,所有测试的羊毛毡对金黄色葡萄球菌、大肠杆菌和铜绿假单胞菌菌株的生长均具有显著的抗菌作用(p < 0.01)。在测试的羊毛毡中,新型Jason G羊毛毡的抗菌效果最弱,但仍足够。在预防感染方面对抗生素效果的评估显示,所应用的羊毛毡之间没有差异。在将羊毛毡手术植入Wistar大鼠背部后,我们观察到,与传统羊毛毡相比,在植入后第5天,磷酸盐缓冲羊毛毡的细胞浸润和微血管形成增加,传统羊毛毡表面有坏死细胞。与酸性羊毛毡不同,在植入后第15天,pH中性羊毛毡被广泛吸收。在此,我们表明,新型pH中性含庆大霉素羊毛毡Jason G在体外对革兰氏阳性和革兰氏阴性细菌均具有良好的总体抗菌效果,且在体内具有改善的降解特性和微血管形成。