title: A bio-artificial poly([D,L]-lactide-co-glycolide) drug-eluting nanofibrous periosteum for segmental long bone open fractures with significant periosteal stripping injuries.
abstract: Biodegradable poly([D,L]-lactide-co-glycolide) (PLGA) nanofibrous membrane embedded with two drug-to-polymer weight ratios, namely 1:3 and 1:6, which comprised PLGA 180 mg, lidocaine 20 mg, vancomycin 20 mg, and ceftazidime 20 mg, and PLGA 360 mg, lidocaine 20 mg, vancomycin 20 mg, and ceftazidime 20 mg, respectively, was produced as an artificial periosteum in the treatment of segmental femoral fractures. The nanofibrous membrane's drug release behavior was assessed in vitro using high-performance liquid chromatography and the disk-diffusion method. A femoral segmental fracture model with intramedullary Kirschner-wire fixation was established for the in vivo rabbit activity study. Twenty-four rabbits were divided into two groups. Twelve rabbits in group A underwent femoral fracture fixation only, and 12 rabbits in group B underwent femoral fracture fixation and were administered the drug-loaded nanofibers. Radiographs obtained at 2, 6, and 12 weeks postoperatively were used to assess the bone unions. The total activity counts in animal behavior cages were also examined to evaluate the clinical performance of the rabbits. After the animals were euthanized, both femoral shafts were harvested and assessed for their torque strengths and toughness. The daily in vitro release curve for lidocaine showed that the nanofibers eluted effective levels of lidocaine for longer than 3 weeks. The bioactivity studies of vancomycin and ceftazidime showed that both antibiotics had effective and sustained bactericidal capacities for over 30 days. The findings from the in vivo animal activity study suggested that the rabbits with the artificial drug-eluting periosteum exhibited statistically increased levels of activity and better clinical performance outcomes compared with the rabbits without the artificial periosteum. In conclusion, this artificial drug-eluting periosteum may eventually be used for the treatment of open fractures.
authors.affiliation: Biomaterials Lab, Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Ying-Chao
authors.initials: YC
authors.lastname: Chou
authors.affiliation: Biomaterials Lab, Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yi-Shiun
authors.initials: YS
authors.lastname: Cheng
authors.affiliation: Biomaterials Lab, Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yung-Heng
authors.initials: YH
authors.lastname: Hsu
authors.affiliation: Biomaterials Lab, Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yi-Hsun
authors.initials: YH
authors.lastname: Yu
authors.affiliation: Biomaterials Lab, Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan; Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Shih-Jung
authors.initials: SJ
authors.lastname: Liu
mesh_terms: D000818:Animals; D002442:Ceftazidime / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D004337:Drug Carriers / Q000737:chemistry*; D005264:Femoral Fractures / Q000188:drug therapy / Q000473:pathology; D005597:Fractures, Open / Q000188:drug therapy* / Q000473:pathology*; D019344:Lactic Acid / Q000737:chemistry*; D008012:Lidocaine / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D008567:Membranes, Artificial; D057139:Nanofibers / Q000737:chemistry*; D010521:Periosteum / Q000187:drug effects* / Q000293:injuries*; D011100:Polyglycolic Acid / Q000737:chemistry*; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011817:Rabbits; D014640:Vancomycin / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D004337:Drug Carriers; D008567:Membranes, Artificial; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D014640:Vancomycin; D008012:Lidocaine; D002442:Ceftazidime
keywords: artificial periosteum; biodegradable poly([d,l]-lactide-co-glycolide) drug-eluting nanofibers; polycaprolactone stents; segmental long bone open fractures