Paryavi Ebrahim, Yanko Moshe, Jaffe David, Nimmgadda Naren, Nouveau Jenna, Schiavone Jason, Gilotra Mohit, Gelb Daniel, Ludwig Steven C
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.
Am J Orthop (Belle Mead NJ). 2014 May;43(5):E98-E104.
Electrical current detaches bacterial biofilm from implanted instrumentation. Hypothetically, this can decrease implant-related infection and allow retention of instrumentation in cases of postoperative wound infections. We conducted a prospective animal study to investigate whether a 60-μAmp implantable direct current (DC) fusion stimulator decreases implant-related infection rates in a multilevel fixed-implant postoperative spinal wound infection model in rabbits. Three dorsal sites, T13, L3, and L6, were instrumented in each rabbit. A 60-μAmp DC fusion stimulator was implanted in a subcutaneous pouch lateral to the instrumented sites, and leads were connected to 2 of 3 sites in each rabbit. All sites were inoculated with methicillin-sensitive Staphylococcus aureus (MSSA). Rabbits were euthanized at 7 days, and cultures were obtained from the surgical sites, including wound swab, bone, and implants. No significant reduction was observed in postoperative infection rates of bone or implant with 60-μAmp DC (95% and 77%, respectively) compared with no current (91% and 82%, respectively) (P > .5). No significant difference was observed in bacterial load (Ps = .25-.72) between sites receiving DC and control sites. Currently used 60-μAmp DC implantable spinal fusion stimulators do not significantly reduce the rate of postoperative implant-related spinal wound infections in a rabbit model.
电流可使细菌生物膜从植入器械上脱落。从理论上讲,这可以降低与植入物相关的感染,并在术后伤口感染的情况下保留器械。我们进行了一项前瞻性动物研究,以调查60微安的植入式直流电(DC)融合刺激器是否能降低兔多级固定植入术后脊柱伤口感染模型中与植入物相关的感染率。在每只兔子的三个背部位置(T13、L3和L6)植入器械。将一个60微安的直流融合刺激器植入器械部位外侧的皮下袋中,并将导线连接到每只兔子三个部位中的两个部位。所有部位均接种对甲氧西林敏感的金黄色葡萄球菌(MSSA)。在第7天对兔子实施安乐死,并从手术部位获取培养物,包括伤口拭子、骨头和植入物。与不通电(分别为91%和82%)相比,60微安直流电组的骨或植入物术后感染率没有显著降低(分别为95%和77%)(P>.5)。接受直流电的部位与对照部位之间的细菌载量没有显著差异(P值为0.25 - 0.72)。目前使用的60微安直流植入式脊柱融合刺激器在兔模型中并不能显著降低术后与植入物相关的脊柱伤口感染率。