Efficacy of a norvancomycin-loaded, PDLLA-coated plate in preventing early infection of rabbit tibia fracture.
Despite improvements in surgical techniques and implant designs in orthopedic surgery, implantation-associated infections are still a challenging problem for surgeons. The goal of this study was to evaluate the efficacy of a norvancomycin-loaded, PDLLA-coated stainless steel plate vs an uncoated stainless steel plate in a rabbit model (n=50). The norvancomycin was delivered from a biodegradable poly(D,L-lactide) (PDLLA) coating of a stainless steel plate. Intraoperatively, rabbit tibia fractures were contaminated with Staphylococcus aureus (10(5) colony forming units) after plate implantation. The implants were either uncoated or coated with PDLLA and norvancomycin. In vivo drug release profiles showed that the norvancomycin release rate was decreased by increasing the time. The norvancomycin concentration in the tissue around the plate was higher than the minimum inhibitory concentration on the 14th day after implantation surgery. The animals were followed up for 28 days. Radiographic examinations were performed, and C-reactive protein and erythrocyte sedimentation rate were determined. Infection was evaluated by histological, microbiological, and radiological analysis. Eight of 25 rabbits (32%) implanted with the norvancomycin-loaded, PDLLA-coated plates were infected. Twenty-three of 25 rabbits (92%) implanted with the uncoated plates were infected (P<.05). The norvancomycin-loaded, PDLLA-coated plate may be used to treat open fractures to reduce the incidence of early infection.
Fei
Jun
J
Traumatic Centre, Research Institute of Surgery, Daping Hospital, Third Military Medical College, Chongqing, 400042, China.
Yu
Hong-jun
HJ
Pan
Chang-jiang
CJ
Zhao
Chang-hong
CH
Zhou
Yong-gang
YG
Wang
Yan
Y
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001799:Blood Sedimentation; D001860:Bone Plates / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000378:metabolism; D011091:Polyesters; D016459:Prosthesis-Related Infections / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control*; D011817:Rabbits; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014640:Vancomycin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
D000900:Anti-Bacterial Agents; D011091:Polyesters; C033616:poly(lactide); D014640:Vancomycin; D002097:C-Reactive Protein; C511195:norvancomycin