[Experimental examination concerning the efficacy of silver-coated Dacron prostheses in vascular graft infections following subcutaneous implantation in a standardized infection model].
It was the aim of the study to examine the efficacy of silver coated prostheses in comparison to Rifampin in impregnated prostheses in the prevention of vascular graft infections.


METHODS
24 C3H/HcN mice with a bodyweight between 24 and 27 grams were assigned to four different groups. GROUP I: control gel-sealed Dacron graft (Uni-Graft DV) (6), GROUP II: gel-sealed Dacron graft (Uni-Graft DV) contaminated locally with 2 x 10(7) CFU/1.2 ml Staphylococcus aureus ATCC 25923 (6), GROUP III: silver prosthesis (Intergard Silver) contaminated locally with 2 x 10(7) CFU/0.2 ml Staphylococcus aureus ATCC 25923 (6), GROUP IV: Rifampin impregnated prosthesis contaminated locally with 2 x 10(7) CFU/0.2 ml Staphylococcus aureus ATCC 25923 (6). 14 days after primary operation all animals were euthanized and the grafts harvested. Specimens were examined for signs of infections by histology and microbiology.


RESULTS
At termination of the trial on day 14 none of the grafts of group I were contaminated. 6 out of 6 grafts in group II, 6 out of 6 grafts in group III and 1 out of 6 grafts in group IV presented with infected grafts. The use of antimicrobial Rifampin could significantly prevent infection after bacterial challenge in group IV.


CONCLUSIONS
The silver protected prosthesis (Intergard Silver) seems to be not effective in protecting vascular infection in vivo. However, the Rifampin group showed excellent results. In conclusion Rifampin bonded gelatin-sealed Dacron grafts are significantly more resistant to bacteremic infection than are silver/collagen-coated Dacron grafts.
Chirurgische Klinik und Poliklinic, Klinikum Grosshadern, Ludwig Maximilians-Universität München, Munich.
T
T
Hernández-Richter
F
F
Wittmann
S
S
Mayr
M
M
Schmitt-Sody
S
S
Blasenbreu
M
M
Wichmann
M M
MM
Heiss
H M
HM
Schardey
M K
MK
Angele
D000818:Animals; D001807:Blood Vessel Prosthesis; D020099:Coated Materials, Biocompatible; D015169:Colony Count, Microbial; D008297:Male; D051379:Mice; D008809:Mice, Inbred C3H; D011093:Polyethylene Terephthalates; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000473:pathology / Q000517:prevention & control*; D012293:Rifampin / Q000494:pharmacology*; D012834:Silver; D013203:Staphylococcal Infections / Q000473:pathology / Q000517:prevention & control*; D040521:Subcutaneous Tissue / Q000473:pathology / Q000601:surgery; D013530:Surgical Wound Infection / Q000473:pathology / Q000517:prevention & control
D020099:Coated Materials, Biocompatible; D011093:Polyethylene Terephthalates; D012834:Silver; D012293:Rifampin