Li Hua, Wang Daofeng, Zhang Wupeng, Xu Gaoxiang, Xu Cheng, Liu Wanheng, Li Jiantao
Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Beijing, China.
Front Bioeng Biotechnol. 2023 Feb 9;11:1111386. doi: 10.3389/fbioe.2023.1111386. eCollection 2023.
The systematic review aimed to determine the potential side effects of antibacterial coatings in orthopaedic implants. Publications were searched in the databases of Embase, PubMed, Web of Science and Cochrane Library using predetermined keywords up to 31 October 2022. Clinical studies reporting side effects of the surface or coating materials were included. A total of 23 studies (20 cohort studies and three case reports) reporting the concerns about the side effects of antibacterial coatings were identified. Three types of coating materials, silver, iodine and gentamicin were included. All of studies raised the concerns regarding safety of antibacterial coatings, and the occurrence of adverse events was observed in seven studies. The main side effect of silver coatings was the development of argyria. For iodine coatings, only one anaphylactic case was reported as an adverse event. No systemic or other general side effects were reported for gentamicin. Clinical studies on the side effects of antibacterial coatings were limited. Based on the available outcomes, the most reported side effects of antibacterial coatings in clinical use were argyria with silver coatings. However, researchers should always pay attention to the potential side effects of antibacterial materials, such as systematic or local toxicity and allergy.
该系统评价旨在确定骨科植入物中抗菌涂层的潜在副作用。截至2022年10月31日，使用预先确定的关键词在Embase、PubMed、Web of Science和Cochrane图书馆数据库中检索出版物。纳入报告表面或涂层材料副作用的临床研究。共确定了23项报告对抗菌涂层副作用担忧的研究（20项队列研究和3例病例报告）。包括三种涂层材料，银、碘和庆大霉素。所有研究均对抗菌涂层的安全性表示担忧，7项研究观察到不良事件的发生。银涂层的主要副作用是银质沉着病。对于碘涂层，仅报告1例过敏病例为不良事件。未报告庆大霉素有全身或其他一般副作用。关于抗菌涂层副作用的临床研究有限。根据现有结果，临床使用中抗菌涂层最常报告的副作用是银涂层导致的银质沉着病。然而，研究人员应始终关注抗菌材料的潜在副作用，如全身或局部毒性以及过敏反应。
