Thierbach Manuela, Müller Michelle, Stange Richard, Kronenberg Daniel, Aurich Matthias, Wildemann Britt
Experimental Trauma Surgery, Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital/Friedrich Schiller University Jena, 07747 Jena, Germany.
Department of Regenerative Musculoskeletal Medicine, Institute for Musculoskeletal Medicine, Westfälische Wilhelms-Universität Münster, 48149 Münster, Germany.
J Clin Med. 2023 Jun 17;12(12):4104. doi: 10.3390/jcm12124104.
Although the rate of infection after the reconstruction of a ruptured anterior cruciate ligament (ACL) is low, prophylactic incubation of the graft with vancomycin (Vanco-wrap or vancomycin soaking) is routinely performed. A cytotoxic effect of vancomycin is reported for several cell types, and the prophylactic treatment might prevent infection but harm the tissue and cells.
A comprehensive study was performed to investigate the effect of vancomycin on tendon tissue and isolated tenocytes using cell viability, molecular and mechanical analysis.
Rat tendons or isolated tenocytes were incubated in increasing concentrations of vancomycin (0-10 mg/mL) for different times, and cell viability, gene expression, histology and Young's modulus were analyzed.
The clinically used concentration of vancomycin (5 mg/mL for 20 min) had no negative effect on cell viability in the tendons or the isolated tenocytes, while incubation with the toxic control significantly reduced cell viability. Increasing the concentration and prolonging the incubation time had no negative effect on the cells. The expression of , and the tenocyte markers , and was not affected by the various vancomycin concentrations. The structural integrity as measured through histological and mechanical testing was not compromised.
The results proved the safe application of the Vanco-wrap on tendon tissue.
IV.
尽管前交叉韧带(ACL)重建术后的感染率较低,但仍常规对移植物进行万古霉素预防性孵育(万古霉素包裹或万古霉素浸泡)。有报道称万古霉素对几种细胞类型具有细胞毒性作用,这种预防性治疗可能预防感染,但会损害组织和细胞。
进行一项全面研究,通过细胞活力、分子和力学分析来研究万古霉素对肌腱组织和分离的肌腱细胞的影响。
将大鼠肌腱或分离的肌腱细胞在浓度不断增加的万古霉素(0 - 10 mg/mL)中孵育不同时间,然后分析细胞活力、基因表达、组织学和杨氏模量。
临床上使用的万古霉素浓度(5 mg/mL,孵育20分钟)对肌腱或分离的肌腱细胞的细胞活力没有负面影响,而与毒性对照孵育则显著降低细胞活力。增加浓度和延长孵育时间对细胞没有负面影响。 、 和肌腱细胞标志物 、 和 的表达不受不同万古霉素浓度的影响。通过组织学和力学测试测得的结构完整性未受到损害。
结果证明了万古霉素包裹在肌腱组织上的安全应用。
IV级。