title: Early host tissue response to different types of vascular prostheses coated with silver acetate or vaporized metallic silver.
abstract: OBJECTIVE
  In vascular surgery, the infection of prosthetic vascular grafts represents a serious life-threatening complication. Due to the increasing resistance of hospital micro-organisms to standard antibiotic therapies, maximum effort should be put in the primary prevention of such infections. For this purpose, grafts may be coated with different antibacterial silver formulations. In the present study the different effects of silver acetate-coating and vaporized metallic silver-coating on the vascularization and perigraft inflammation during the initial phase after implantation of Intergard Silver (IS) and Silver Graft (SG) were compared.
  
  
  METHODS
  Silver acetate-coated IS and vaporized metallic silver-coated SG were implanted into the dorsal skinfold chamber of C57BL/6 mice (n = 8 per group) to study angiogenesis and leukocyte inflammation at the implantation site by means of repetitive intravital fluorescence microscopy over a 14-day period. At the end of the in vivo experiments, apoptosis and cell proliferation in the newly developed granulation tissue surrounding the implants was analyzed by immunohistochemistry.
  
  
  RESULTS
  IS exhibited an improved vascularization, resulting in a significantly higher functional capillary density when compared to SG. Moreover, the leukocyte inflammatory response to IS was less pronounced, as indicated by a reduced number of adherent leukocytes in perigraft venules. This was associated with a higher proliferative activity of the granulation tissue incorporating the IS when compared to SG. The numbers of apoptotic cells in the perigraft tissue were low and did not differ between the two groups.
  
  
  CONCLUSIONS
  Silver acetate-coated IS exhibits an improved vascularization and reduced perigraft inflammation during the first 14 days after implantation when compared to vaporized metallic silver-coated SG. This may contribute to reducing the risk of early perigraft seroma formation and subsequent infection.
authors.affiliation: Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg/Saar, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Jeanmonod
authors.affiliation: Institute for Clinical and Experimental Surgery, University of Saarland, Homburg/Saar, Germany.
authors.forename: M W
authors.initials: MW
authors.lastname: Laschke
authors.affiliation: Institute for Clinical and Experimental Surgery, University of Saarland, Homburg/Saar, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Gola
authors.affiliation: Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg/Saar, Germany.
authors.forename: M
authors.initials: M
authors.lastname: von Heesen
authors.affiliation: Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg/Saar, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Glanemann
authors.affiliation: Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg/Saar, Germany.
authors.forename: M D
authors.initials: MD
authors.lastname: Menger
authors.affiliation: Institute for Clinical and Experimental Surgery, University of Saarland, Homburg/Saar, Germany; Department of Vascular and Endovascular Surgery, Saint Bonifatius Hospital, Lingen/Ems, Germany. Electronic address: mamal@gmx.de.
authors.forename: M R
authors.initials: MR
authors.lastname: Moussavian
mesh_terms: D000085:Acetates / Q000008:administration & dosage* / Q000009:adverse effects; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017209:Apoptosis; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D049109:Cell Proliferation; D020099:Coated Materials, Biocompatible; D005549:Foreign-Body Reaction / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D007249:Inflammation / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D051379:Mice; D008810:Mice, Inbred C57BL; D018919:Neovascularization, Physiologic; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000517:prevention & control; D018030:Silver Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors
chemical_list: D000085:Acetates; D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D018030:Silver Compounds; C103100:silver acetate
keywords: Angiogenesis; Dacron grafts; Dorsal skinfold chamber; Inflammation; Silver acetate; Vaporized silver; Vascularization