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Highly Adhesive Antimicrobial Coatings for External Fixation Devices.

Mikhail Bredikhin1, Sushant Sawant1, Christopher Gross2

  • 1Department of Bioengineering, Clemson University, Clemson, SC 29634, USA.

Gels (Basel, Switzerland)
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New gel coatings for orthopedic pins offer strong adhesion and antimicrobial properties, significantly reducing the risk of pin site infections and improving fracture fixation outcomes.

Keywords:
K-wiresPGMAantimicrobial gelschitosanhighly adherentorthopedic implants

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Infectious Disease Prevention

Background:

  • Percutaneous pinning techniques disrupt the skin barrier, leading to pin site infections, with rates up to 100% after external fixation.
  • Pin site infections can cause loosening, increased pain, and more severe complications like osteomyelitis, necessitating effective prevention strategies.
  • Current antimicrobial coatings for orthopedic implants often suffer from poor adhesion, detaching under shear forces during implantation.

Purpose of the Study:

  • To develop highly adhesive, drug-eluting coatings for orthopedic pins to prevent pin site infections.
  • To create novel gel coatings that maintain antimicrobial efficacy after implantation under shear stress.
  • To reduce the morbidity and cost associated with implant-associated infections in orthopedic procedures.

Main Methods:

  • Development of two gel coating types: synthetic poly-glycidyl methacrylate-based and natural chitosan-based.
  • Testing coating adhesion to pins under strong shear forces, simulating implantation conditions.
  • Incorporation of antibiotics into the gel coatings and evaluation of antimicrobial efficacy on bone-implanted K-wires.

Main Results:

  • Both synthetic and natural gel coatings demonstrated strong adhesion to pins, withstanding significant shear forces without damage.
  • Antibiotic-loaded K-wires with the developed coatings retained antimicrobial efficacy after implantation and removal from bone.
  • The coatings proved robust, suggesting potential for improved antimicrobial delivery in orthopedic implants.

Conclusions:

  • Novel synthetic and chitosan-based gel coatings offer a promising solution for enhancing the antimicrobial efficacy and durability of orthopedic pins.
  • These highly adhesive coatings can effectively deliver antibiotics and resist dislodgement, addressing a key limitation of current technologies.
  • The developed coating technology has the potential to significantly reduce the incidence and impact of pin site infections in orthopedic surgery.