The efficacy of controlled antibiotic release for prevention of polyethyleneterephthalate- (Dacron-) related infection in cardiovascular surgery.
Infection of prostheses containing polyethyleneterephthalate (Dacron) remains a dreaded complication in cardiovascular surgery despite perioperative antibiotic (AB) prophylaxis.  Dacron, which is widely applied as a fabric for manufacturing vascular prostheses and also the sewing rings of artificial heart valves, remains a source for infection once implanted in the body.  In order to increase the AB concentration in Dacron, an experimental study including topical application of the gentamicin derivative EMD 46/217 and fibrin sealant (F) as AB carrier was initiated.  In-vitro pretreatment of Dacron with the gentamicin derivative and F was followed by constant AB release for three weeks. In a subsequent animal study, four Dacron rings with different pretreatments were implanted in the descending aorta of ten pigs after direct contamination with 10 8 Staph. aureus solution. One ring was pretreated with the AB/F compound, a second ring with the AB alone. Ring 3 (no pretreatment) and ring 4 (F alone) served as controls.  After one week, the Dacron rings and their corresponding implantation sites were asserved for measurement of AB content and for culture.  The AB content of AB/F rings was 24.99 +/- 7.16 mug/g wet weight, while Dacron rings pretreated with the AB alone contained no measurable drug amounts, with the exception of one specimen (0.5 mug/g)(AB/F versus AB rings: P less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)
Division of Thoracic and Cardiovascular Surgery, Surgical Center, Hannover Medical School, Germany.
M
M
Karck
L
L
Forgione
A
A
Haverich
D000287:Administration, Topical; D000818:Animals; D001807:Blood Vessel Prosthesis; D016503:Drug Delivery Systems; D015718:Fibrin Tissue Adhesive; D005839:Gentamicins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006350:Heart Valve Prosthesis; D011093:Polyethylene Terephthalates / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D012995:Solubility; D013552:Swine