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Interaction between vascular prostheses and rifampicin in the prevention of the grafts infection. An experimental
1Institute of Vascular Surgery, School of Veterinary, University of Bologna, Italy.
Abstract:
Infections caused by synthetic prostheses are relatively rare (1.5-6%) but serious complication in vascular surgery. There is no doubt that during and immediately after surgery bacterial contamination may occur. An in vitro study was carried out in the Vascutek laboratories, which revealed a high affinity between prostheses in Dacron gel and Rifampicin. This affinity, the result of an ionic bond, was demonstrated by the fact that after 5 days Rifampicin was still present on the prostheses. Encouraged by this result, an experimental study was carried out in sheep. Five sheep were operated on making a prosthetic graft in both of the common carotid arteries: on one side a Gelseal Dacron prosthesis was implanted after being soaked for 15 minutes in a solution containing 1 mg/ml Rifampicin. A Knitted Dacron prosthesis was implanted in the contralateral carotid artery, again after pretreatment with Rifampicin. Explants were made after 2, 24, 48, 72 and 96 hours, and the concentration of Rifampicin on the prostheses was assessed on the basis of the diameter of the inhibition area on Staphylococcus aureus cultures. The results showed that the Gelseal Dacron prostheses maintained Rifampicin concentrations with an antibacterial activity up to 72 hours; this property disappears with the Knitted Dacron prostheses after only 24 hours. These results confirm the high affinity of Gelseal Dacron and Rifampicin also in in vivo experimental models.
Insights
Rifampicin shows high affinity for Gelseal Dacron prostheses, maintaining antibacterial activity for up to 72 hours in sheep. Knitted Dacron prostheses lost this activity within 24 hours, indicating Gelseal
Area of Science:
- Vascular Surgery
- Biomaterials Science
- Infectious Diseases
Background:
- Infections associated with synthetic vascular prostheses are a serious complication, occurring in 1.5-6% of cases.
- Bacterial contamination of prostheses can happen during or immediately after surgery.
- Rifampicin is an antibiotic with potential for use in preventing prosthesis infections.
Purpose of the Study:
- To investigate the in vitro and in vivo affinity of Dacron prostheses for Rifampicin.
- To compare the duration of Rifampicin's antibacterial activity on two types of Dacron prostheses: Gelseal and Knitted.
Main Methods:
- In vitro study assessing Rifampicin binding to Dacron gel prostheses.
- In vivo experimental study in sheep implanting Rifampicin-soaked Gelseal and Knitted Dacron prostheses in carotid arteries.
- Assessment of Rifampicin concentration via Staphylococcus aureus inhibition zones at 2, 24, 48, 72, and 96 hours post-implantation.
Main Results:
- Gelseal Dacron prostheses demonstrated sustained Rifampicin concentrations with antibacterial activity for up to 72 hours.
- Knitted Dacron prostheses exhibited antibacterial activity from Rifampicin for only 24 hours.
- In vitro studies confirmed a strong ionic bond and high affinity between Rifampicin and Dacron gel prostheses.
Conclusions:
- Gelseal Dacron prostheses exhibit a significantly longer retention of Rifampicin and sustained antibacterial activity compared to Knitted Dacron prostheses.
- These findings support the potential of using Rifampicin-coated Gelseal Dacron prostheses to reduce infection rates in vascular surgery.