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Experimental study on bacterial colonization of fibrin glue and its prevention
1Department of Cardiovascular Surgery, Iwakuni National Hospital, Japan.
Abstract:
To assess the possibility of bacterial colonization of fibrin glue and the effects of adding local sustained-release antibiotics, we conducted in vivo and in vitro preliminary studies. The in vitro experiments revealed that, although there was no colonization of the fibrin glue plates by the eight strains of bacteria tested, the fibrin mesh can serve as a culture medium when blood mingles with it, as is the case in clinical use. Adding dibekacin sulfate (DKB; 3570 micrograms/mL) to fibrin glue decreased the likelihood of colonization of the fibrin mesh. The pharmacokinetics of the added DKB were investigated by adding DKB-supplemented fibrin glue directly to muscle and vascular tissue in male rats. The DKB rapidly eluded from the fibrin glue (less than 0.2% remained after 24 hours). Because the amount remaining after 7 days (2.03 micrograms/mL) was greater than the minimum inhibitory concentration for most clinical pathogens, a 7-day preventive effect against colonization of the fibrin glue and the surrounding tissue can be anticipated at the concentration used in the present experiments. Experiments using the dermis layer of porcine skin strips showed that the added DKB did not affect the adhesive strength of the fibrin glue.
Insights
Adding dibekacin sulfate (DKB) to fibrin glue helps prevent bacterial colonization, even though DKB elutes rapidly. This antibiotic-loaded fibrin glue maintains adhesive strength, offering a potential 7-day protective effect against infection.
Area of Science:
- Biomaterials Science
- Infectious Disease Research
- Surgical Adhesives
Background:
- Fibrin glue is used in surgery but can be colonized by bacteria when mixed with blood.
- Local antibiotics may prevent bacterial contamination of surgical materials.
- The efficacy and safety of antibiotic-loaded fibrin glue require investigation.
Purpose of the Study:
- To evaluate bacterial colonization of fibrin glue.
- To assess the impact of adding dibekacin sulfate (DKB) on fibrin glue's anti-bacterial properties and pharmacokinetics.
- To determine if DKB affects the adhesive strength of fibrin glue.
Main Methods:
- In vitro studies with eight bacterial strains and fibrin glue plates.
- In vivo pharmacokinetic analysis of DKB-elution from fibrin glue in rat muscle and vascular tissue.
- Assessment of DKB's effect on the adhesive strength of fibrin glue using porcine skin strips.
Main Results:
- Fibrin glue itself did not support bacterial colonization, but blood contamination created a culture medium.
- Adding dibekacin sulfate (DKB) to fibrin glue reduced bacterial colonization likelihood.
- DKB eluted rapidly from fibrin glue ( <0.2% after 24 hours), but concentrations remained above minimum inhibitory levels for 7 days.
- DKB did not compromise the adhesive strength of fibrin glue.
Conclusions:
- Antibiotic-supplemented fibrin glue can prevent bacterial colonization of the glue and surrounding tissues for at least 7 days.
- Dibekacin sulfate-loaded fibrin glue offers a promising option for reducing surgical site infections without compromising adhesive properties.