Prevention of graft infection by bonding of gentamycin to Dacron prostheses Axel Haverich, MD, Stephan Hirt, MD, Matthias Karck, MD, Francesco Siclari,

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Presentation transcript:

Prevention of graft infection by bonding of gentamycin to Dacron prostheses Axel Haverich, MD, Stephan Hirt, MD, Matthias Karck, MD, Francesco Siclari, MD, Helmut Wahlig, MD Journal of Vascular Surgery Volume 15, Issue 1, Pages 187-193 (January 1992) DOI: 10.1016/0741-5214(92)70027-I Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Four steel rings (diameter, 9 mm), covered with Dacron and mounted on a steel wire at 2 cm segments for implantation in the descending aorta. Journal of Vascular Surgery 1992 15, 187-193DOI: (10.1016/0741-5214(92)70027-I) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Elution rates of antibiotic out of Dacron samples in phosphate buffer (pH, 7.4) pretreated with gentamycin and gentamycin plus fibrin sealant over 21 days. Although gentamycin from Dacron samples pretreated with antibiotic is washed out almost completely after 3 days, the antibiotic in Dacron samples pretreated with antibiotic/fibrin is retained by fibrin sealant resulting in a delayed drug release into the environment with a peak after 3 days and a slow decline until day 21. (Mean values and SEM; antibiotic vs antibiotic/fibrin from day 1 to day 3: p < 0.001, from day 4 to day 14: p < 0.05). Journal of Vascular Surgery 1992 15, 187-193DOI: (10.1016/0741-5214(92)70027-I) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Mean diameters of inhibitory zones of gentamycin plus fibrin sealant and Dacron samples pretreated with gentamycin placed on culture plates inoculated with B. subtilis. No difference in diameters is found until day 8. From day 9 until the end of the experiment the diameters of Dacron samples pretreated with antibiotic become progressively smaller indicating previous washout of antibiotic (Mean values and SEM; antibiotic vs antibiotic/fibrin day 10: p < 0.05; from day 11 to day 21: p < 0.001). Journal of Vascular Surgery 1992 15, 187-193DOI: (10.1016/0741-5214(92)70027-I) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Gentamicin content in Dacron sewing rings (left) and in the tissues of the corresponding implantation sites (right) depending on the mode of pretreatment after 7 days of implantation (gentamycin/fibrin sealant vs gentamycin in sewing rings; p < 0.0005; in the implantation sites: p < 0.0005; mean values and SEM). Journal of Vascular Surgery 1992 15, 187-193DOI: (10.1016/0741-5214(92)70027-I) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions