title: Gentamicin supplementation of polyvinylidenfluoride mesh materials for infection prophylaxis.
abstract: Hernia repair evolved from pure tissue repair to mesh repair due to decreased recurrence rates. However, concern exists about mesh-related infections occurring even several years after initial operation. Therefore, a polyvinylidenfluoride (PVDF) mesh material was constructed and surface modified by plasma-induced graft polymerization of acrylic acid (PVDF+PAAc). Antimicrobial treatment was sought by binding of gentamicin (PVDF+PAAc+Gentamicin). In vitro efficacy and cytotoxicity was measured by agar diffusion test, L929 cytotoxicity testing and by analyzing the amount of gentamicin release from the mesh surface. In vivo biocompatibility was evaluated in 45 Sprague-Dawley rats. 7, 21 and 90 days after mesh implantation the amount of inflammatory and connective tissue as well as the percentage of proliferating (Ki67) and apoptotic cells (TUNEL) were analyzed at the perifilamentary region. Agar diffusion tests showed sufficient local antimicrobiotic effects against the bacteria tested after 24h of incubation. No signs of cytotoxicity could be identified by L929 testing. Furthermore, surface modification did not affect the in vivo biocompatibility. At the end of the observation period, no significant differences were found for the perifilamentary amount of inflammatory cells and connective tissue and the percentage of Ki67 and TUNEL positive stained cells. The presented data confirm that an antibiotic surface modification of PVDF mesh samples is feasible. By analyzing cytotoxicity in vitro as well as biocompatibility in vivo no side effects were observed.
authors.affiliation: Department of Surgery, German Centre of Excellence for Biomaterial and Implant Pathology, Technical University of Aachen, Aachen, Germany. karsten.junge@post.rwth-aachen.de
authors.forename: Karsten
authors.initials: K
authors.lastname: Junge
authors.forename: Raphael
authors.initials: R
authors.lastname: Rosch
authors.forename: Uwe
authors.initials: U
authors.lastname: Klinge
authors.forename: Carsten
authors.initials: C
authors.lastname: Krones
authors.forename: Bernd
authors.initials: B
authors.lastname: Klosterhalfen
authors.forename: Peter R
authors.initials: PR
authors.lastname: Mertens
authors.forename: Petra
authors.initials: P
authors.lastname: Lynen
authors.forename: Dagmar
authors.initials: D
authors.lastname: Kunz
authors.forename: Achim
authors.initials: A
authors.lastname: Preiss
authors.forename: Heidrun
authors.initials: H
authors.lastname: Peltroche-Llacsahuanga
authors.forename: Volker
authors.initials: V
authors.lastname: Schumpelick
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry; D001424:Bacterial Infections / Q000517:prevention & control*; D002478:Cells, Cultured; D020099:Coated Materials, Biocompatible / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry*; D003131:Combined Modality Therapy; D016503:Drug Delivery Systems / Q000379:methods*; D004343:Drug Implants / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry; D005240:Feasibility Studies; D005347:Fibroblasts / Q000187:drug effects / Q000473:pathology; D005549:Foreign-Body Reaction / Q000209:etiology / Q000473:pathology; D005839:Gentamicins / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry*; D020007:Implants, Experimental; D008297:Male; D008422:Materials Testing; D051379:Mice; D011145:Polyvinyls / Q000737:chemistry*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013526:Surgical Mesh; D005465:Fluorocarbon Polymers
chemical_list: D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D004343:Drug Implants; D005839:Gentamicins; D011145:Polyvinyls; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers