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Chitosan-coated Stainless Steel Screws for Fixation in Contaminated Fractures

机译:壳聚糖涂层不锈钢螺钉用于固定受污染的骨折

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摘要

Stainless steel screws and other internal fixation devices are used routinely to stabilize bacteria-contaminated bone fractures from multiple injury mechanisms. In this preliminary study, we hypothesize that a chitosan coating either unloaded or loaded with an antibiotic, gentamicin, could lessen or prevent these devices from becoming an initial nidus for infection. The questions investigated for this hypothesis were: (1) how much of the sterilized coating remains on the screw with simulated functional use; (2) is the unloaded or loaded chitosan coating bacteriostatic and biocompatible; and (3) what amount and rate does an antibiotic elute from the coating? In this study, the gentamicin eluted from the coating at a detectable level during 72 to 96 hours. The coating was retained at the 90% level in simulated bone screw fixation and the unloaded and loaded chitosan coatings had encouraging in vitro biocompatibility with fibroblasts and stem cells and were bacteriostatic against at least one strain of Staphylococcus aureus. The use of an antibiotic-loaded chitosan coating on stainless steel bone screws and internal fixation devices in contaminated bone fracture fixation may be considered after optimization of antibiotic loading and elution and more expanded in vitro and in vivo investigations with other organisms and antibiotics.
机译:常规上使用不锈钢螺钉和其他内部固定装置来稳定受多种损伤机制污染的细菌污染的骨折。在这项初步研究中,我们假设未装载或装载有抗生素庆大霉素的壳聚糖涂层可以减少或防止这些装置成为最初的感染病菌。针对该假设所调查的问题是:(1)在模拟功能使用的情况下,有多少无菌涂层保留在螺杆上; (2)是已卸载或已装载的壳聚糖涂层具有抑菌和生物相容性; (3)抗生素从涂层中洗脱的量和速率是多少?在这项研究中,庆大霉素在72至96小时内以可检测的水平从涂层中洗脱出来。该涂层在模拟的骨螺钉固定中保留在90%的水平,未加载和已加载的壳聚糖涂层在体外与成纤维细胞和干细胞的生物相容性令人鼓舞,并且对至少一种金黄色葡萄球菌具有抑菌作用。优化抗生素加载和洗脱后,可以考虑在不锈钢骨螺钉和内部固定装置上使用载有抗生素的壳聚糖涂层进行污染的骨折固定,并在其他生物和抗生素的体外和体内研究中进一步扩大应用范围。

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