Medium-term results of the treatment of periprosthetic infection with carbon-coated spacers impregnated with silver

IF 0.3 Q4 ORTHOPEDICS Travmatologiya i ortopediya Rossii Pub Date : 2023-11-10 DOI:10.17816/2311-2905-7997
Leonid I. Malyuchenko, Nikolay S. Nikolaev, Vadim V. Yakovlev, Elena V. Preobrazhenskaya
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Abstract

The aim of the study to evaluate the antibacterial activity and biological compatibility of alloy coatings based on two-dimensionally ordered linear chain carbon (TDOLCC) and medium-term results of treatment of periprosthetic infection with their use. Materials and Methods. Coatings based on TDOLCC were synthesized using alloying additions like nitrogen (TDOLCC+N) and silver (TDOLCC+Ag) on the surfaces of titanium plates and polystyrene plates by the ion-stimulated carbon condensation in a vacuum. The authors examined the superficial bactericidal activity of the coatings and its resistance to mechanical effects. The rate of formation of microbial biofilms by clinical isolates with multiple and extreme resistance to antibiotics was assessed by staining the samples with a solution of crystal violet. The cytotoxic effect of the coatings was evaluated in relation to the primary culture of fibroblasts and keratinocyte cells of the HaCaT line. Results. The authors observed pronounced superficial bactericidal effect of TDOLCC+Ag coating in respect of microorganisms of several taxonomic groups independently of their resistance to antibacterial drugs. TDOLCC+Ag coating proved capable to completely prevent microbial biofilm formation by antibiotic resistant clinical isolates of S. aureus and P. aeruginosa. Silvercontaining coating demonstrated mechanical resistance and preservation of close to baseline level of superficial bactericidal activity even after lengthy abrasion treatment. TDOLCC based coatings did not cause any cytotoxic effects. Structure of monolayers formed in cavities coated by TDOLCC+N and TDOLCC+Ag was indistinguishable from the monolayers in cavities of control plates. Conclusions. The high anti-film activity of DU LCC+Ag coatings was proved in experiment and clinical practice at the follow-up stage. The use of a spacer with a test coating allows you to quickly eliminate the inflammatory process, significantly reduce the number of relapses of PJI in cases of CS and TB infections, and reduce the number of hospital stay days. Evaluation of the mid-term results of PJI treatment gives grounds to predict active protection of the implant surface from colonization by microorganisms and the formation of microbial biofilms, which, together with drug antibiotic prophylaxis, provides a good therapeutic and prophylactic effect on the recurrence of periprosthetic infection.
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浸银碳包覆垫片治疗假体周围感染的中期结果
本研究的目的是评价基于二维有序线性链碳(TDOLCC)合金涂层的抗菌活性和生物相容性,以及使用该涂层治疗假体周围感染的中期效果。材料与方法。采用离子激发碳在真空中缩合的方法,在钛板和聚苯乙烯板表面添加氮(TDOLCC+N)和银(TDOLCC+Ag)合金,合成了TDOLCC涂层。研究了涂层的表面杀菌活性及其对机械效应的抵抗能力。采用结晶紫染色法对具有多重和极端耐药的临床分离株进行微生物生物膜的形成速率评估。通过对HaCaT系成纤维细胞和角质形成细胞的原代培养,评价了涂层的细胞毒性作用。结果。作者观察到,TDOLCC+Ag涂层对不同种类的微生物具有明显的表面杀菌作用,而不影响其对抗菌药物的耐药性。TDOLCC+Ag涂层能够完全阻止金黄色葡萄球菌和铜绿假单胞菌耐药临床分离株形成微生物生物膜。含银涂层表现出机械阻力和保存接近基线水平的表面杀菌活性,即使经过长时间的磨损处理。基于TDOLCC的涂层没有引起任何细胞毒性作用。TDOLCC+N和TDOLCC+Ag涂层的空腔中形成的单层结构与对照板的空腔中形成的单层结构没有区别。结论。在后续的实验和临床实践中证实了DU LCC+Ag涂层具有较高的抗膜活性。使用带有测试涂层的间隔器可以快速消除炎症过程,显着减少CS和TB感染病例中PJI的复发次数,并减少住院天数。通过对PJI治疗中期结果的评估,可以预测种植体表面对微生物定植的积极保护和微生物生物膜的形成,与药物抗生素预防一起,对假体周围感染的复发具有良好的治疗和预防作用。
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CiteScore
0.60
自引率
66.70%
发文量
56
审稿时长
8 weeks
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Medium-term results of the treatment of periprosthetic infection with carbon-coated spacers impregnated with silver SUGGESTIONS FOR INTRODUCING SOME NEW TERMS IN PELVIC AND ACETABULAR SURGERY Correction of multiapical deformities of the lower libs: Review Knee arthroplasty in real clinical practice: analysis of 36,350 cases from the register of the Vreden National Medical Center of Trauma and Ortopedics ORTHOPEDICS IN THE FOCUS OF INTELLECTUAL PROPERTY
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