title: Bactericidal micron-thin sol-gel films prevent pin tract and periprosthetic infection.
abstract: Orthopedic injuries constitute the majority of wounds sustained by U.S. soldiers in recent conflicts. The risk of infection is considerable with fracture fixation devices. In this pilot study, we examined the use of unique bactericidal micron-thin sol-gel films on fracture fixation devices and their ability to prevent and eradicate infections. External fixation was studied with micron-thin sol-gel coated percutaneous pins releasing triclosan and inserted medially into rabbit tibiae. A total of 11 rabbits received percutaneous pins that were either uncoated or sol-gel/triclosan coated. Internal fracture fixation was also studied using sol-gel coated intramedullary (IM) nails releasing vancomycin in the intramedullary tibiae. Six sheep received IM nails that were coated with a sol-gel film that either contained vancomycin or did not contain vancomycin. All animals were challenged with Staphylococcus aureus around the implant. Animals were euthanized at 1 month postoperative. Rabbits receiving triclosan/sol-gel coated percutaneous pins did not show signs of infection. Uncoated percutaneous pins had a significantly higher infection rate. In the sheep study, there were no radiographic signs of osteomyelitis with vancomycin/sol-gel coated IM nails, in contrast to the observations in the control cohort. Hence, the nanostructured sol-gel controlled release technology offers the promise of a reliable and continuous delivery system of bactericidals from orthopedic devices to prevent and treat infection.
authors.affiliation: Department of Bioengineering, Center for Bioactive Materials and Tissue Engineering, University of Pennsylvania, 210 South 33rd Street, Philadelphia, PA 19104.
authors.forename: Haibo
authors.initials: H
authors.lastname: Qu
authors.affiliation: Department of Experimental Orofacial Medicine, Philipps University, Georg-Voigt-Street 3, D-35039 Marburg, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Knabe
authors.affiliation: Comparative Orthopaedic Research Laboratory, Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, 382 West Street Road, Kennett Square, PA 19348.
authors.forename: Megan
authors.initials: M
authors.lastname: Burke
authors.affiliation: Department of Bioengineering, Center for Bioactive Materials and Tissue Engineering, University of Pennsylvania, 210 South 33rd Street, Philadelphia, PA 19104.
authors.forename: Shula
authors.initials: S
authors.lastname: Radin
authors.affiliation: Department of Orthopaedic Surgery, University of Pennsylvania, 424 Stemmler Hall, 36th and Hamilton Walk, Philadelphia, PA 19104.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Garino
authors.affiliation: Comparative Orthopaedic Research Laboratory, Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, 382 West Street Road, Kennett Square, PA 19348.
authors.forename: Thomas
authors.initials: T
authors.lastname: Schaer
authors.affiliation: Department of Bioengineering, Center for Bioactive Materials and Tissue Engineering, University of Pennsylvania, 210 South 33rd Street, Philadelphia, PA 19104.
authors.forename: Paul
authors.initials: P
authors.lastname: Ducheyne
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D001858:Bone Nails / Q000382:microbiology*; D016503:Drug Delivery Systems; D005260:Female; D005782:Gels; D008297:Male; D049329:Nanostructures / Q000627:therapeutic use*; D010865:Pilot Projects; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D011817:Rabbits; D012756:Sheep; D013203:Staphylococcal Infections / Q000517:prevention & control*; D014260:Triclosan / Q000008:administration & dosage; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D005782:Gels; D014260:Triclosan; D014640:Vancomycin