Sakamoto Yoshiaki, Ochiai Hiroko, Ohsugi Ikuko, Inoue Yoshikazu, Yoshimura Yoko, Kishi Kazuo
Department of Plastic and Reconstructive Surgery, Keio University School of Medicine.
Neurol Med Chir (Tokyo). 2014;54(8):647-53. doi: 10.2176/nmc.oa.2013-0295. Epub 2014 Mar 27.
Treatment of calvarial defects has remained a challenge in reconstruction surgery, especially because of infection at these sites. We produced a bactericidal biomaterial for treating infected bone defects by using calcium phosphate bone cement mixed with antibiotics. We evaluated the usefulness of this material mixed with the antibiotic vancomycin in a cranium-infected rat model. The concentration of vancomycin used was 5.0 wt%, as reported in our previous study. In order to establish the rat model, a cranium defect (diameter, 5 mm) was made that was infected with methicillin-resistant Staphylococcus aureus (MRSA). Thirty-six rats were divided into 6 groups depending on whether an autologous graft or bone cement with or without antibiotic was used for the defect. After 1 and 4 weeks, abscess formation was checked, tissue bacterial counts were determined, and pathological examination was performed. At both 1 and 4 weeks, no MRSA was detected on tissue bacterial culture or pathological examination in groups that received bone cement with antibiotics. In groups that received bone cement without antibiotic, MRSA was detected, and the bone cement had compromised and disintegrated into several slices. In conclusion, bone cement that contains antibiotics appears to be effective not only for reconstruction in cases of cranial defect, but also in terms of preventing infection.
颅骨缺损的治疗在重建手术中一直是一项挑战，尤其是因为这些部位容易发生感染。我们通过将磷酸钙骨水泥与抗生素混合，制备了一种用于治疗感染性骨缺损的杀菌生物材料。我们在颅骨感染的大鼠模型中评估了这种与抗生素万古霉素混合的材料的有效性。如我们之前的研究所报道，使用的万古霉素浓度为5.0 wt%。为了建立大鼠模型，制作了一个直径为5 mm的颅骨缺损，并使其感染耐甲氧西林金黄色葡萄球菌（MRSA）。根据缺损处使用自体移植物还是含或不含抗生素的骨水泥，将36只大鼠分为6组。1周和4周后，检查脓肿形成情况，测定组织细菌计数，并进行病理检查。在1周和4周时，接受含抗生素骨水泥的组在组织细菌培养或病理检查中均未检测到MRSA。在接受不含抗生素骨水泥的组中，检测到了MRSA，并且骨水泥已经受损并分解成几片。总之，含抗生素的骨水泥似乎不仅对颅骨缺损病例的重建有效，而且在预防感染方面也有效。
