A DESCRIPTIVE STUDY OF BACTERIOLOGICAL SPECTRUM OF ORTHOPEDIC IMPLANT INFECTION IN CLOSED FRACTURES

Background: Surgical Site Infection (SSI) is defined as pain associated with erythema, induration, local tenderness, pus discharge or any culturepositive or negative discharge from a surgically created wound. Methods: Hospital based Descriptive type of Observational study conducted on Patients in the department of Orthopaedics. Results: Total 5.00% patients have wound infection. Gram positive 80.00% patients have found with Staph. Aureus and Gram negative 20.00%patients have found with Pseudomonas. Conclusion: Infection in closed fractures with implants was quite high. The adverse outcome of SSIs related to a clean orthopedic surgical procedure can be associated with significant morbidity, cost, and even mortality. Keywords: Infection, SSI, Fracture

Antibacterial and Anti-Inflammatory Coating Materials for Orthopedic Implants: A Review

Orthopedic implant failure is the most common complication of orthopedic surgery, causing serious trauma and resulting in a tremendous economic burden for patients. There are many reasons for implant failure, among which peri-implant infection (or implant-related infection) and aseptic loosening are the most important. At present, orthopedic doctors have many methods to treat these complications, such as revision surgery, which have shown good results. However, if peri-implant infection can be prevented, this will bring about significant social benefits. Many studies have focused on adding antibacterial substances to the implant coating, and with a deeper understanding of the mechanism of implant failure, adding such substances by different modification methods has become a research hot spot. This review aims to summarize the antibacterial and anti-inflammatory substances that can be used as coating materials in orthopedic implants and to provide a reference for the prevention and treatment of implant failure caused by implant-related infection and excessive inflammation.

A DESCRIPTIVE STUDY OF BACTERIOLOGICAL SPECTRUM OF ORTHOPEDIC IMPLANT INFECTION IN CLOSED FRACTURES

Background- Surgical Site Infection (SSI) is defined as pain associated with erythema, induration, local tenderness, pus discharge or any culture positive or negative discharge from a surgically created wound. Methods- Descriptive type of Observational study conducted on Patients in the department of Orthopaedics. Results- 6.00% patients have wound infection. Gram positive 83.33% patients have found with Staph. Aureus and Gram- negative 16.67% patients have found with Pseudomonas. Conclusion- Infection in closed fractures with implants was quite high. The adverse outcome of SSIs related to a clean orthopedic surgical procedure can be associated with significant morbidity, cost, and even mortality. Keywords- SSI, Closed, Implants

A Comparative Analysis on the Curative Effects of Different Treatment for Infections Around Dental Implants

Objective: To analyze and evaluate the clinical efficacy of different treatment options for patients with peri-implant infection. Methods: The study period was from June 2019 to June 2020. Seventy-six patients with peri-implant infection that were treated in Stomatological Hospital of Hefei were selected as study samples. The patients were divided into a research group and a control group by random number table method in which the sample size of each group was n=38. Patients in the control group were treated with drugs combined with ultrasonic cleaning while patients in the research group were treated with guided bone regeneration combined with flap curettage. The indicators of the two groups were compared and analyzed. Results: The plaque index (PLI), probing depth (PD), and sulcus bleeding index (SBI) of the two groups after treatment were lower than those before treatment (P < 0.05). There was no significant difference between the groups (P > 0.05). However, the height of the implant marginal bone of the study group after treatment was higher than that of the control group (P < 0.05). Conclusion: The use of guided bone regeneration combined with flap curettage for patients with infection around dental implants promotes the fusion of bone and implants. The clinical effect was significant and this should be comprehensively promoted in medical institutions at all levels.

Implant infections after breast reconstruction surgery following mastectomy: Experience from a Greek breast unit

BACKGROUND: Despite the dominance of implant-based breast reconstruction after mastectomy, during recent years, it has been correlated to some complications. The aim of this study is to present the Greek experience about management of implant infections after breast reconstructions and to investigate the relationship between possible risk factors and breast pocket fluid cultures. METHODS: In total, 260 patients underwent implant-based breast reconstruction due to breast cancer in our center from 2016 until 2020. 46 patients, that underwent implant or expander replacement after breast reconstruction due to mastectomy were included in the present study. RESULTS: 260 patients underwent breast reconstruction in our center and in 46 (18%) of them an implant replacement was required. 21 patients (8%) presented clinically with an implant infection, but 12 of them (5%) had positive cultures from the breast pocket fluid. On the contrary, 25 patients (10%) presented no clinical signs of implant infection, but 5 of them (2%) had a positive culture. In addition, we demonstrated a correlation between implant infection and positive cultures (p = 0.009), along with an association between chemotherapy before implant placements and negative cultures (p = 0.035). Finally, the most common pathogen was Staphylococcus epidermidis (29%), followed by Escherichia coli (24%) and Staphylococcus aureus (18%). CONCLUSION: Implant infection still remains a very serious complication after breast reconstruction surgery. The establishment of a therapeutic protocol, with specific antimicrobial and surgical targets seems as an effective strategy against implant infections.

Non-contact induction heating and SAAP-148 eliminate persisters within MRSA biofilms mimicking a metal implant infection

Implant-associated infections are the primary cause of complications following orthopaedic surgery. Due to biofilm and persister formation, current treatments, i.e. surgical debridement followed by antibiotics, often fail. There is an urgent need for alternative strategies to combat such infections. Therefore, the present study investigated the effects of non-contact induction heating (NCIH), the antimicrobial peptide SAAP-148 and combinations thereof on bacterial counts in 7 d mature biofilms and in persister-enriched biofilms of methicillin-resistant Staphylococcus aureus (MRSA) on titanium-aluminium-niobium (TAN) discs. Enrichment of persisters was achieved by daily exposure of mature biofilms to high doses of rifampicin and ciprofloxacin for 3 consecutive days. To heat up the TAN discs, a miniaturised induction heater was built and successfully validated. Using this apparatus, NCIH resulting in surface temperatures up to 85 °C eradicated all the bacteria in immature biofilms but not in mature biofilms, whereas persisters were already eliminated at surface temperatures ≥ 70 °C. SAAP-148 at concentrations > 25.6 µmol/L reduced the persister counts in antibiotics-exposed, mature biofilms. As surface temperatures > 60 °C can have detrimental effects on the surrounding tissues, the maximum temperature of NCIH used in combination with SAAP-148 on persisters was set to 60 °C. Results revealed that this combination was slightly more effective than the peptide or NCIH alone in eliminating biofilm-embedded persisters. NCIH and SAAP-148 can be applied both invasively and non-invasively in various treatment scenarios. Together, combinations of NCIH and SAAP-148 might be a promising treatment strategy to combat metal-implant-associated infections.