title: The Effect of Negative Pressure Wound Therapy With Antiseptic Instillation on Biofilm Formation in a Porcine Model of Infected Spinal Instrumentation.
abstract: OBJECTIVE
  This study evaluates the effect of negative pressure wound therapy with antiseptic instillation (NPWTi) in the clearance of infection and biofilm formation in an in vivo model of infected spinal implants compared to traditional treatment modalities.
  
  
  METHODS
  Five pigs underwent titanium rod implantation of their spinous processes followed by injection of 1 x 106 CFUs/100μL of methicillin-resistant Staphylococcus aureus through the fascia at each site. At 1 week postoperatively, an experimental arm of 3 pigs received NPWTi, and a control arm of 2 pigs received wet-to-dry dressings. The persistence of local infection in the experimental group was compared to the control group using tissue cultures. Biofilm development on spinal implants was evaluated using scanning electron microscopy.
  
  
  RESULTS
  Mean bacterial count showed a statistical difference between the experimental and the control groups (P < .05). Scanning electron microscopy revealed the presence of uniform biofilm formation across the surface of control group instrumentation, whereas the experimental group showed interrupted areas between biofilm formations.
  
  
  CONCLUSIONS
  The authors concluded that NPWTi is associated with decreased bacterial load and biofilm formation compared to wet-to-dry dressings in an in vivo porcine model of infected spinal instrumentation.
authors.affiliation: Division of Plastic Surgery, Anne Arundel Medical Center, Annapolis, MD.
authors.forename: Devinder P
authors.initials: DP
authors.lastname: Singh
authors.affiliation: Section of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, CT.
authors.forename: Arvind U
authors.initials: AU
authors.lastname: Gowda
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of Maryland School of Medicine, Baltimore, MD; Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Karan
authors.initials: K
authors.lastname: Chopra
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Michael
authors.initials: M
authors.lastname: Tholen
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Sarah
authors.initials: S
authors.lastname: Chang
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Mavrophilipos
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Nina
authors.initials: N
authors.lastname: Semsarzadeh
authors.affiliation: Division of Plastic Surgery, Anne Arundel Medical Center, Annapolis, MD.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Rasko
authors.affiliation: Division of Plastic Surgery, Anne Arundel Medical Center, Annapolis, MD.
authors.forename: Luther
authors.initials: L
authors.lastname: Holton Iii
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000494:pharmacology; D058491:Bacterial Load / Q000187:drug effects; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development; D001850:Bone Diseases, Infectious / Q000382:microbiology / Q000628:therapy*; D004195:Disease Models, Animal; D004866:Equipment Contamination; D016268:Internal Fixators / Q000382:microbiology*; D008855:Microscopy, Electron, Scanning; D054843:Negative-Pressure Wound Therapy; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000628:therapy*; D013131:Spine / Q000382:microbiology / Q000473:pathology*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000628:therapy*; D013552:Swine; D014945:Wound Healing
chemical_list: D000891:Anti-Infective Agents, Local