Highly Adhesive Antimicrobial Coatings for External Fixation Devices.
Highly Adhesive Antimicrobial Coatings for External Fixation Devices.
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DOI：
10.3390/gels9080639
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发表时间：
2023-08-08
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影响因子：
--
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针位感染源于使用经皮钉钉技术（如骨骼牵引、经皮骨折钉钉和骨折稳定或复杂畸形重建的外固定）。这些部位是感染的病灶，因为皮肤屏障被破坏，允许细菌进入以前的特权区域。外固定后，针部感染率可达100%。销钉部位感染后，销钉可能松动，引起疼痛增加（增加麻醉的使用）并降低骨折或畸形矫正装置的固定。更严重的并发症包括骨髓炎和深部组织感染。由于其并发症和后遗症的相关费用，减少针部感染的策略是至关重要的。目前预防种植体相关感染的策略包括抗生素涂层、抗菌聚合物和肽、银以及其他防腐剂，如氯己定和银磺胺嘧啶。在骨科植入物上，特别是在被称为克氏针（或k -丝）的针上开发抗菌涂层面临的问题包括药物洗脱层的粘附性差，在植入过程中很容易被剪切力去除。因此，高粘附性药物洗脱涂层的开发可以提高这些设备的抗菌功效，并最终减少针位感染的负担。针对这一需求，我们开发了两种类型的凝胶涂料：合成聚甲基丙烯酸缩水甘油酯和天然壳聚糖为基础的。干燥后，这些凝胶涂层表现出很强的附着力，并在施加强剪切力后保持不变。我们还证明了抗生素可以掺入这些凝胶中，并且具有这种涂层的k线在钻入骨头并从骨头中取出后仍保持抗菌效果。这种涂层对于k形丝和其他在植入过程中经历强剪切力的矫形植入物来说是无价的。
Pin site infections arise from the use of percutaneous pinning techniques (as seen in skeletal traction, percutaneous fracture pinning, and external fixation for fracture stabilization or complex deformity reconstruction). These sites are niduses for infection because the skin barrier is disrupted, allowing for bacteria to enter a previously privileged area. After external fixation, the rate of pin site infections can reach up to 100%. Following pin site infection, the pin may loosen, causing increased pain (increasing narcotic usage) and decreasing the fixation of the fracture or deformity correction construct. More serious complications include osteomyelitis and deep tissue infections. Due to the morbidity and costs associated with its sequelae, strategies to reduce pin site infections are vital. Current strategies for preventing implant-associated infections include coatings with antibiotics, antimicrobial polymers and peptides, silver, and other antiseptics like chlorhexidine and silver-sulfadiazine. Problems facing the development of antimicrobial coatings on orthopedic implants and, specifically, on pins known as Kirschner wires (or K-wires) include poor adhesion of the drug-eluting layer, which is easily removed by shear forces during the implantation. Development of highly adhesive drug-eluting coatings could therefore lead to improved antimicrobial efficacy of these devices and ultimately reduce the burden of pin site infections. In response to this need, we developed two types of gel coatings: synthetic poly-glycidyl methacrylate-based and natural-chitosan-based. Upon drying, these gel coatings showed strong adhesion to pins and remained undamaged after the application of strong shear forces. We also demonstrated that antibiotics can be incorporated into these gels, and a K-wire with such a coating retained antimicrobial efficacy after drilling into and removal from a bone. Such a coating could be invaluable for K-wires and other orthopedic implants that experience strong shear forces during their implantation.
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影响因子：
3.7
作者：
Gulcu A;Akman A;Demirkan AF;Yorukoglu AC;Kaleli I;Bir F
通讯作者：
Bir F
DOI：
10.1007/s11552-008-9153-8
发表时间：
2009-06-01
期刊：
Hand (New York, N.Y.)
影响因子：
--
作者：
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通讯作者：
Kon, Moshe
影响因子：
2.3
作者：
Franssen BB;van Diest PJ;Schuurman AH;Kon M
通讯作者：
Kon M
影响因子：
2.7
作者：
Back, David Alexander;Bormann, Nicole;Wildemann, Britt
通讯作者：
Wildemann, Britt
影响因子：
0.6
作者：
Batin, Sabri;Ozan, Firat;Altay, Taskin
通讯作者：
Altay, Taskin