Tang LiangHua, Zhao ChangHong, Xiong Yan, Pan ChangJiang, Wang AiMin
Department of Orthopedics, Daping Hospital, Third Military Medical University, Chongqing, China.
Orthopedics. 2009 May;32(5):324. doi: 10.3928/01477447-20090501-16.
The rate of infection in closed fractures is low and ranges from 0.7% to 4.2%. Patients with open fractures are known to be at higher risk of infection (5%-30%). Internal fixation of fractures is widely used; however, implants allow bacteria to grow and propagate. Implant-associated infections are the chief risk facing orthopedic and traumatology departments. It would therefore be clinically advantageous to develop an internal fixation system that possesses anti-infection properties to prevent and cure implant infections. With poly(D,L)-lactic acid (PDLLA) as a carrier, PDLLA coatings carrying vancomycin were prepared on the surface of titanium alloy plate substrates for internal fixation of fractures using solvent-casting technology. The bacteriostatic activity to Staphylococcus aureus and the drug-release profile of the plates were evaluated in vitro. Vancomycin-loaded plates showed a sustained in vitro drug release character in the experiment. The in vitro inhibition of S aureus showed that the plates had an inhibitory effect on S aureus, and the antibacterial activity was maintained for at least 15 days. These findings may have important clinical significance for preventing acute infection after the fracture of internally implanted fixation plates.
闭合性骨折的感染率较低，在0.7%至4.2%之间。已知开放性骨折患者感染风险更高（5% - 30%）。骨折内固定术被广泛应用；然而，植入物会使细菌生长和繁殖。植入物相关感染是骨科和创伤科面临的主要风险。因此，开发一种具有抗感染特性的内固定系统以预防和治疗植入物感染在临床上将具有优势。以聚（D，L）-乳酸（PDLLA）为载体，采用溶剂浇铸技术在用于骨折内固定的钛合金板基底表面制备了载万古霉素的PDLLA涂层。在体外评估了这些板材对金黄色葡萄球菌的抑菌活性和药物释放曲线。载万古霉素的板材在实验中呈现出持续的体外药物释放特性。对金黄色葡萄球菌的体外抑制实验表明，这些板材对金黄色葡萄球菌有抑制作用，且抗菌活性至少维持15天。这些发现对于预防内植入固定钢板骨折后的急性感染可能具有重要的临床意义。
