在聚甲基甲酸盐水泥中使用高剂量和低剂量的万科米辛:有效性和机械性能
Jeffrey W Kwong1, Michael Abramowicz2, Klaus Dieter Kühn3
1Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA 94143, USA.
Antibiotics (Basel, Switzerland)
|September 28, 2024
概括
抗生素水泥间隔剂中的高剂量万科米辛用于假肢关节感染 (PJI) 改善了抗菌性质,但损害了机械稳定性. 预制间隔器,如Copal Exchange G提供持续的疗效,可能是两个阶段修改手术的首选.
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:
- 假肢关节感染 (PJI) 带来了重大治疗挑战.
- 使用带有抗生素的水泥间隔器进行的两阶段修复手术是美国晚发性PJI的标准.
- 优化抗生素化和间隔器的机械性能至关重要.
研究的目的:
- 为了评估不同剂量的万科米辛在充满抗生素的水泥间隔器中的疗效.
- 为了比较高剂量和低剂量的万科米辛的生物机械和抗菌性质.
- 评估用于PJI处理的预制间隔器.
主要方法:
- 手动添加低 (2g) 和高 (6g) 剂量的万科米辛到Copal水泥 (gentamicin + clindamycin或万科米辛).
- 在体外机械测试 (ISO 5833,DIN 53435) 和抑制区对PJI病原体的测定.
- 对商业上可用的预制间隔器 (Copal Exchange G,Cemex Spacer-K) 的评估.
主要成果:
- 高剂量的万科米辛 (6g) 损害了机械稳定性,不符合ISO标准.
- 所有测试的万科米辛剂量 (低剂量和高剂量) 显示持续42天的抗菌疗效.
- 与Cemex Spacer-K.K.相比,Copal Exchange G在6周内显示出明显更大,更一致的抑制区.
结论:
- 增加的万科米辛度增强了抗菌活性,但降低了水泥间隔器的机械稳定性.
- 预制的Copal Exchange G间隔器提供持续的广泛的抗菌疗效.
- 由于其抗微生物性能和生物力学特性,Copal Exchange G可能是双阶段修复手术的首选选择.
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