title: In vivo testing of an infection-resistant vascular graft material.
abstract: Present prosthetic arterial conduits continue to suffer the clinically and economically catastrophic complication of infection. We recently described a novel technique for binding quinolone antibiotics to Dacron based on principles of textile chemistry. This thermofixation procedure ("pad/heat") utilizes the limited fibrophilic characteristics of the quinolone antibiotic ciprofloxacin (Cipro) to permit pad/heat application and allowed controlled, sustained release from Dacron in several in vitro assays. The objective of this study was to test this infection-resistant prosthetic vascular graft material in an in vivo model. Dacron segments (1 cm2, either plain, dipped into antibiotic immediately prior to implantation, or Cipro pad/heat treated) were implanted in the dorsal subcutaneous tissue of the rabbit and directly contaminated with 10(6) Staphylococcus aureus. After 1 week, the samples were sterily harvested. Wounds were blindly graded on a scale from 1 (no evidence of infection, good tissue incorporation) to 4 (suppurative infection extending outside of the graft pocket, no gross tissue incorporation). Plain Dacron was easily infected in this model (mean grade 3.1 +/- 0.6, 92% culture positive). Notably, however, a significant (P < 0.05) wound grade difference between the dipped (2.3 +/- 1.0) and pad/heat (1.4 +/- 0.6) samples was demonstrated. Determination of adherent bacteria present on the implanted Dacron pieces by sonication and culture studies again revealed a significant difference between the dipped (56% culture positive) and pad/heat (12% culture) groups (P < 0.025). Histologic studies confirmed good tissue incorporation of the pad/heat samples. This project opens new avenues in the development of infection-resistant biomaterials.
authors.affiliation: New England Deaconess Hospital/Harvard Medical School, Boston, Massachusetts 02215.
authors.forename: C K
authors.initials: CK
authors.lastname: Ozaki
authors.forename: M D
authors.initials: MD
authors.lastname: Phaneuf
authors.forename: M J
authors.initials: MJ
authors.lastname: Bide
authors.forename: W C
authors.initials: WC
authors.lastname: Quist
authors.forename: J M
authors.initials: JM
authors.lastname: Alessi
authors.forename: F W
authors.initials: FW
authors.lastname: LoGerfo
mesh_terms: D000818:Animals; D001422:Bacterial Adhesion; D001424:Bacterial Infections / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D002939:Ciprofloxacin / Q000008:administration & dosage*; D006358:Hot Temperature; D008264:Macrophages / Q000473:pathology; D009504:Neutrophils / Q000473:pathology; D011093:Polyethylene Terephthalates; D016459:Prosthesis-Related Infections / Q000473:pathology / Q000517:prevention & control*; D011817:Rabbits; D013203:Staphylococcal Infections / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D011093:Polyethylene Terephthalates; D002939:Ciprofloxacin