Gentamicin supplementation of polyvinylidenfluoride mesh materials for infection prophylaxis.
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.
Junge
Karsten
K
Department of Surgery, German Centre of Excellence for Biomaterial and Implant Pathology, Technical University of Aachen, Aachen, Germany. karsten.junge@post.rwth-aachen.de
Rosch
Raphael
R
Klinge
Uwe
U
Krones
Carsten
C
Klosterhalfen
Bernd
B
Mertens
Peter R
PR
Lynen
Petra
P
Kunz
Dagmar
D
Preiss
Achim
A
Peltroche-Llacsahuanga
Heidrun
H
Schumpelick
Volker
V
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
D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D004343:Drug Implants; D005839:Gentamicins; D011145:Polyvinyls; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers