American Association of Plastic Surgeons

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Novel Antibiotic Thin Films Prevent Surgical Implant Infections
Jennifer Baker, MD1, Ahmed Beydoun, BS1, Ryan Boudreau, MD1, Aaron Seitz, MD1, W. John Kitzmiller, MD1, Michael J. Edwards, MD1, Charles Caldwell, PhD1, Erich Gulbins, PhD2, Ryan M. Gobble, MD1.
1Department of Surgery, University of Cincinnati, Cincinnati, OH, USA, 2Departemnt of Molecular Biology, University of Duisburg-Essen, Essen, Germany.

Purpose:
Many plastic surgery procedures involve implantation of foreign bodies. Implantable materials range from silicone breast implants, to expanded polytetrafluorethylene (ePTFE) facial implants, to titanium plates, screws, and wires. Surgical implant-associated infections are associated with significant morbidity and increased costs. We have developed a novel method of coating surgical implants that is inexpensive, easy, and effective at preventing implant infection in vivo.
Methods:
Pieces of silicone, ePTFE, and titanium were coated with ethanol, doxycycline, erythromycin, chloramphenicol, and levofloxacin using our novel dip-coating method.
Wildtype mice underwent sterile subcutaneous implantation of either antibiotic-coated or vehicle- coated silicone, ePTFE, or titanium. Methicillin resistant S. aureus (MRSA) or P. aeruginosa in saline was directly inoculated into the wound. After three days, mice were sacrificed, and the implants were harvested and subjected to bath sonication to release adherent bacteria. Bacterial counts were quantified using a plate dilution method.
Results:
Silicone coated with doxycycline reduced MRSA and P. aeruginosa implant colonization by 3.8 log and 2.6 log, respectively. Titanium coated with erythromycin, doxycycline, chloramphenicol, and levofloxacin reduced MRSA and P. aeruginosa implant colonization by 3.2, 4.7, 2.3, and 3.7 log and 3.3, 2.7, 2.8, and 3.7 log respectively. Titanium coated with erythromycin, doxycycline, chloramphenicol, and levofloxacin reduced MRSA and P. aeruginosa implant colonization by 2.5, 2.6, 2.3, and 2.9 log, and 0.3, 2.8, 2.4, and 3.3 respectively (p<0.5.)
Conclusion:
Wound infection is the dreaded complication of foreign body implantation. We present a method for coating surgical implants that demonstrates marked reduction of implant infection.


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