Absorbable, delayed-release antibiotic beads reduce surgical wound infection.
Absorbable, polyglycolic acid (PGA) beads were evaluated as a new vehicle for local antibiotic delivery. Incisions on the dorsa of guinea pigs were contaminated with 1 x 10(8) Escherichia coli and 1 x 10(8) Staphylococcus aureus. PGA beads containing either minocycline, amikacin, or no antibiotic (placebo) were placed into these wounds and compared to animals treated with systemic minocycline or amikacin alone. The diameter of wound erythema was measured daily for 7 days. Serial blood and wound quantitative cultures were obtained, and serum and wound antibiotic concentrations were determined. Both minocycline-PGA and amikacin-PGA-treated wounds exhibited less erythema than placebo-PGA wounds (P < 0.05). All minocycline-PGA and amikacin-PGA-treated wounds healed primarily, whereas 67 per cent of placebo-PGA wounds developed purulence, dehisced, and healed secondarily. Local antibiotic delivery was more effective than systemic administration in reducing wound erythema and the number of bacteria in wound quantitative cultures. E. coli and S. aureus were quantitatively reduced (P < 0.05) in wounds of antibiotic PGA-treated animals compared to those in placebo-PGA-treated and systemic minocycline and systemic amikacin-treated animals. Measurable minocycline and amikacin concentrations were present in antibiotic-PGA-treated wounds through day 3, without detectable serum levels. Delayed-release, absorbable, antibiotic-containing PGA beads effectively prevent infection in contaminated wounds and have the advantage of not requiring vehicle removal.
Galandiuk
S
S
Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Kentucky 40292, USA.
Wrightson
W R
WR
Young
S
S
Myers
S
S
Polk
H C
HC
D000583:Amikacin / Q000008:administration & dosage*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D004343:Drug Implants; D004927:Escherichia coli Infections / Q000517:prevention & control*; D006168:Guinea Pigs; D008297:Male; D008911:Minocycline / Q000008:administration & dosage*; D011100:Polyglycolic Acid; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D004343:Drug Implants; D011100:Polyglycolic Acid; D000583:Amikacin; D008911:Minocycline