手动添加万科米到聚甲基甲酸 (PMMA) 水泥的影响
Clemens Kittinger1, Michael Eder-Halbedl2, Klaus Dieter Kühn3
1Development and Research Insitute of Hygiene, Microbiology and Environmental Medicine, Hygiene Medical University of Graz, Neue Stiftingtalstraße 6/III 1, 8010 Graz, Austria.
Antibiotics (Basel, Switzerland)
|August 29, 2024
概括
在周围假肢关节感染时,将万科米辛添加到骨水泥中,可以降低机械稳定性和抗生素释放效率. 虽然有些水泥符合规格,但有些水泥不符合规格,影响治疗的有效性.
科学领域:
- 整形外科手术 整形外科手术
- 生物材料科学 生物材料科学
- 传染性疾病 传染性疾病
背景情况:
- 抗生素通常被添加到骨中,以治疗周围假肢关节感染.
- 在修复手术中,抗生素度不足需要额外的添加剂,可能会改变水泥的特性.
- 作为外科医生的外科医生.
- 制造商是制造商的制造商,制造商是制造商的制造商.
- 骨水泥的机械性能和抗菌性能需要明确.
研究的目的:
- 评估抗生素添加剂对骨水泥机械稳定性的影响.
- 评估从骨水泥中添加的抗生素的功能和释放量.
- 为了比较商业上可用的米辛和氨基糖化物装载骨水泥与手工增强的配方.
主要方法:
- 两种工业制造的菌素-PMMA水泥 (VancogenX®,Copal® G+V) 和两种添加菌素的PMMA水泥 (Smartset® GHV,抗生素Simplex® T) 的比较.
- 通过ISO曲强度和曲模块测试来评估机械稳定性.
- 使用高性能液体染色学 (HPLC) 和修改的Kirby-Bauer试验确定抗生素释放和功能.
主要成果:
- 在所有测试的水泥中观察到初始高抗生素释放.
- 在VancogenX®和Smartset® GHV的24小时后观察到抗生素效率降低.
- 几天内检测到功能性抗生素释放,但VancogenX®在第21天失去了活性.
- 手动添加万科米辛显著降低了ISO曲强度 (10-15 mPal),而Smartset® GHV未能满足ISO 5833标准.
- 与VancogenX®相比,Copal® G+V的长期化效果更好.
结论:
- 建议手动将2g的万科米辛添加到40g的PMMA粉末中,用于对甲素耐药的葡萄球菌感染.
- 范科米辛的释放超过了长达42天的葡萄球菌最低抑制度 (MIC).
- 手动添加万科米的PMMA水泥的机械性能可能不符合ISO规格.
- 与VancogenX®相比,Copal® G+V随着时间的推移表现出更好的抗生素化.
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