Abstract | BACKGROUND: In hernia surgery, soaking of meshes in antibiotics before implantation is a prophylactic strategy for minimizing the risk of infection while providing minimal, local, drug doses. This study describes the development and application of an antibacterial mesh coating comprising a carboxymethylcellulose gel loaded with rifampicin in a preclinical model of Staphylococcus aureus and S. epidermidis infection in rabbits. METHODS: Antibacterial activity and cytocompatibility (with fibroblasts) of unloaded carboxymethylcellulose gel and 0.13 mg/mL rifampicin- carboxymethylcellulose gel were assessed in vitro. Then, partial abdominal wall defects (5 × 2 cm) were created in New Zealand white rabbits (n = 34), the wound inoculated with 0.25 mL of 106 CFU Staphylococcus aureus/ S. epidermidis (n = 17 each), and the defect then repaired with a lightweight, monofilament, large pore polypropylene mesh either uncoated (n = 3) or coated with carboxymethylcellulose gel (n = 7) or rifampicin- carboxymethylcellulose gel (n = 7). By postoperative day 14, coating performance was evaluated by determining bacterial adhesion (via sonication), host tissue incorporation (via histology), macrophage response via immunostaining), and bloodstream drug diffusion (via high-performance liquid chromatography). RESULTS: CONCLUSION: Soaking meshes in rifampicin- carboxymethylcellulose gel inhibited effectively the bacterial adhesion to the mesh without compromising the tissue repair. This antibiotic gel constitutes an easy-to-use and effective prophylactic strategy that potentially reduce the prevalence of postoperative mesh infection.
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Authors | Bárbara Pérez-Köhler, Selma Benito-Martínez, Francisca García-Moreno, Marta Rodríguez, Gemma Pascual, Juan M Bellón |
Journal | Surgery
(Surgery)
Vol. 167
Issue 3
Pg. 598-608
(03 2020)
ISSN: 1532-7361 [Electronic] United States |
PMID | 31785825
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2019 Elsevier Inc. All rights reserved. |
Chemical References |
- Anti-Bacterial Agents
- Carboxymethylcellulose Sodium
- Rifampin
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Topics |
- Animals
- Anti-Bacterial Agents
(administration & dosage)
- Antibiotic Prophylaxis
(instrumentation)
- Carboxymethylcellulose Sodium
(administration & dosage)
- Disease Models, Animal
- Hernia, Abdominal
(surgery)
- Herniorrhaphy
(adverse effects, instrumentation, methods)
- Humans
- Male
- Microbial Sensitivity Tests
- Rabbits
- Rifampin
(administration & dosage)
- Staphylococcal Infections
(microbiology, prevention & control)
- Staphylococcus aureus
(drug effects, isolation & purification)
- Staphylococcus epidermidis
(drug effects, isolation & purification)
- Surgical Mesh
- Surgical Wound Infection
(microbiology, prevention & control)
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