PIN TRACT INFECTIONS: SILVER VS UNCOATED PINS

Orthopedics - Tập 17 Số 5 - Trang 445-448 - 1994
Cory A. Collinge1, George Goll, David Seligson, K. Jack Easley
1Dept of Orthopedic Surgery, University of Louisville, KY 40292.

Tóm tắt

ABSTRACT To test the hypothesis that coating external fixation pins with a silver-containing compound (Spi-Argent, Spire Corp, Bedford, Mass) will reduce bacterial colonization and/ or pin tract infection, 36 silver-coated and 12 conventional stainless steel pins were placed in the iliac crest of six sheep and inoculated with Staphylococcus aureus. After 2 ½ weeks the pin sites were examined for motion and inflammation, and the pin tips were quantitatively cultured and examined with scanning electron microscopy (SEM). We found that 84% of the uncoated pins were infected, while 62% of the silver-coated pins were infected. Silver-coated pins were less frequently infected than uncoated pins (confidence interval [CI] >85%). Also, silver-coated pins were loose less frequently than uncoated pins. Pin motion was closely correlated with infection: 28 of 32 infected pins (88%) had motion, while only 9 of 16 uninfected pins (56%) had motion (CI >80%). SEM study of the pin tips showed a decreased level of glycocalyx-protected colonization on the surface of the silver-coated pins. Clinically, these results suggest that silver-coated pins will result in less infection and motion at the pin site, the most significant problems in external fixation.

Từ khóa


Tài liệu tham khảo

1. Green S. Complications of external skeletal fixation. Clin Orthop 1983; 180:109-116.

2. Behrens F Scarfs K. External fixation of the tibia. J Bone Joint Surg. 1986; 688:246-254.

3. Harkess J Ramsey W Harkess J. External fixation of fractures. In: Rockwood C Green D Bucholz R eds. Fractures in Adults. Philadelphia Pa: JB Lippincott Co; 1991:54-78.

4. Mahan J Seligson D Henry S Hynes P Dobbins J. Factors in pin tract infections. Orthopedics. 1991; 14:305-308.

5. Cristina A Costerton J. Bacterial adherence to biomaterials and tissue. / Bone Joint Surg. 1985; 67A:264-273.

6. Cristina A Costerton J Webb L. Microbial adhesion biofilms and the pathophysiology of osteomyelitis. In: D'Ambrosia R Marier R eds. Orthopedic Infections. ?????fare NJ: Slack Ine; 1989:49-69.

7. Dobbins J Seligson D Raff M. Bacterial colonization of orthopedic fixation devices in the absence of clinical infection. / Infect Dis. 1988; 158:203-205.

8. Lyons V Henry S1 Fahgri M Seligson D. Bacterial adherence to plain and tobramycin polymethylmethacrylate beads. Clin Orthop. 1992; 278:260-264.

9. Burny F El Baña S Evrard E. Traitement des fractures simples du tibia par osteotaxis. Acta Orthop Belg. 1979;45(l):33-46.

10. Respet P Kleinman P Meinhard B. Pin tract infections: a canine model. J Orthop Res. 1987; 5:600-603.

11. Mayberry-Carson K Tober-Meyer B Smith J Lambe D Costerton J. Bacterial adherence and glycocalyx formation in osteomyelitis experimentally induced with Staphylococcus aureus. Infect Immun. 1984; 43:825-833.

12. Becker B Spadaro J. Treatment of orthopedic infections with electrically generated silver ions. / Bone Joint Surg. 1978;60A:871-891.

13. Hill W Pillsbury D. Argyria the Pharmacology of Silver. Baltimore Md: Williams & Wilkins; 1939.

14. Modak S Fox C. Binding of silver sulfadiazine to the cellular components of Pseudomonas aeruginosa. Biochem Pharmacol. 1973; 22:2391-2404.

15. Parkhill C. A new apparatus for the fixation of bones after resection and in fractures with a tendency to displacement. Transactions of the American Surgeons Association. 1897; 15:25 1-258.

16. Seligson D. External fixation: a devotee's view. Seminars in Orthopedics. 1986; 1:253-263.

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Orthopedics

Tập 17 Số 5

445-448

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