Collinge C A, Goll G, Seligson D, Easley K J
Dept of Orthopedic Surgery, University of Louisville, KY 40292.
Orthopedics. 1994 May;17(5):445-8. doi: 10.3928/0147-7447-19940501-11.
To test the hypothesis that coating external fixation pins with a silver-containing compound (Spi-Argent, Spire Corp, Bedford, Mass) will reduce bacterial colonization and/or pin tract infection, 36 silver-coated and 12 conventional stainless steel pins were placed in the iliac crest of six sheep and inoculated with Staphylococcus aureus. After 2 1/2 weeks the pin sites were examined for motion and inflammation, and the pin tips were quantitatively cultured and examined with scanning electron microscopy (SEM). We found that 84% of the uncoated pins were infected, while 62% of the silver-coated pins were infected. Silver-coated pins were less frequently infected than uncoated pins (confidence interval [CI] > 85%). Also, silver-coated pins were loose less frequently than uncoated pins. Pin motion was closely correlated with infection: 28 of 32 infected pins (88%) had motion, while only 9 of 16 uninfected pins (56%) had motion (CI > 80%). SEM study of the pin tips showed a decreased level of glycocalyx-protected colonization on the surface of the silver-coated pins. Clinically, these results suggest that silver-coated pins will result in less infection and motion at the pin site, the most significant problems in external fixation.
为了验证用含银化合物（Spi-Argent，Spire公司，马萨诸塞州贝德福德）包裹外固定针会减少细菌定植和/或针道感染这一假设，将36根镀银针和12根传统不锈钢针植入6只绵羊的髂嵴，并接种金黄色葡萄球菌。2.5周后，检查针部位有无活动和炎症，对针尖进行定量培养并用扫描电子显微镜（SEM）检查。我们发现，84%的未镀银针发生感染，而镀银针的感染率为62%。镀银针的感染频率低于未镀银针（置信区间[CI]＞85%）。此外，镀银针松动的频率也低于未镀银针。针的活动与感染密切相关：32根感染针中有28根（88%）有活动，而16根未感染针中只有9根（56%）有活动（CI＞80%）。对针尖的SEM研究显示，镀银针表面糖萼保护的定植水平降低。临床上，这些结果表明镀银针将减少针部位的感染和活动，这是外固定中最严重的问题。
