PDF(Pubmed)
Abstract：
Although the incidence of infections in orthopedic surgeries, including periprosthetic surgeries, remains low at approximately 1-2%, the number of surgeries and the incidence of drug-resistant bacteria is increasing. The cost and morbidity associated with revision surgeries are huge. More effective drug combinations and delivery methods are urgently needed. In this paper, three anti-infective drugs (vancomycin, rifampicin, and silver sulfadiazine) have been jointly and effectively electrospun in thin (0.1 mm) flexible nanofiber mats of either poly (methyl methacrylate) (PMMA) or poly (lactic-co-glycolic acid) (PLGA). The inclusion of poly (ethylene glycol) (PEG) enabled optimal drug release with a reduced water contact angle for wetting. The controlled release of these three agents from 20% PEG (w/w to polymer)-blended PMMA or PLGA nanofiber mats may allow for the prophylactical prevention of implant-related infections or provide methods to treat orthopedic infections at the time of revision surgeries. These combinations of drugs provide excellent additive or synergistic antibiotic action against a broader spectrum of bacteria than each drug alone.
摘要：
虽然骨科手术中感染的发生率，包括假体周围手术,保持在大约1-2%的低位，手术数量和耐药细菌的发病率正在增加。与翻修手术相关的成本和发病率是巨大的。迫切需要更有效的药物组合和递送方法。在本文中,三种抗感染药物（万古霉素，利福平,和磺胺嘧啶银）已在聚（甲基丙烯酸甲酯）（PMMA）或聚（乳酸-共-乙醇酸）（PLGA）的薄（0.1mm）柔性纳米纤维垫中联合有效地静电纺丝。包含聚(乙二醇)(PEG)能够实现最佳的药物释放,具有降低的用于润湿的水接触角。这三种药剂从20%PEG(w/w至聚合物)-共混的PMMA或PLGA纳米纤维垫的受控释放可允许预防性预防植入物相关感染或提供在翻修手术时治疗骨科感染的方法。这些药物的组合比单独的每种药物对更广谱的细菌提供了优异的附加或协同抗生素作用。
