Limits...
Development of a Novel Model for the Assessment of Dead-Space Management in Soft Tissue.

Oliver RA, Lovric V, Yu Y, Christou C, Aiken SS, Cooper JJ, Walsh WR - PLoS ONE (2015)

Bottom Line: Complete resorption was confirmed radiographically at 3 weeks post-implantation.Serological inflammatory cytokine expression for IL-6, TNF-α and IL-1β indicated no unusual inflammatory response to the implanted materials or surgical procedure.The two materials tested were effective in resolving the surgically created dead space, and did not elicit any unexpected adverse host response.

View Article: PubMed Central - PubMed

Affiliation: Surgical & Orthopaedic Research Laboratories, University of New South Wales Australia, Sydney, Australia, Prince of Wales Clinical School, Prince of Wales Hospital, Randwick, NSW, Australia.

ABSTRACT
Following extensive surgical debridement in the treatment of infection, a "dead space" can result following surgical closure that can fill with hematoma, an environment conducive to bacterial growth. The eradication of dead space is essential in order to prevent recurrent infection. This study describes a novel small animal model to investigate dead-space management in muscle tissue. Two absorbable test materials were implanted in each animal; beads of calcium sulfate alone, and beads loaded with vancomycin and tobramycin. In-life blood samples and radiographs were taken from each animal following implantation. Animals were sacrificed at 1, 7, 21, 42, and 63 days post-operatively (n = 4), and implant sites were analysed by micro-computed tomography, histology and immunohistochemistry. Complete resorption was confirmed radiographically at 3 weeks post-implantation. Histologically, the host tissue response to both materials was identical, and subsequent healing at the implant sites was observed with no dead space remaining. Vancomycin was not detected in blood serum. However, peak tobramycin levels were detected in all animals at 6 hours post-implantation with no detectable levels in any animals at 72 hours post implantation. Serological inflammatory cytokine expression for IL-6, TNF-α and IL-1β indicated no unusual inflammatory response to the implanted materials or surgical procedure. The model was found to be convenient and effective for the assessment of implant materials for management of dead space in muscle tissue. The two materials tested were effective in resolving the surgically created dead space, and did not elicit any unexpected adverse host response.

No MeSH data available.


Related in: MedlinePlus

Implantation of beads.Beads were implanted into individual implantation sites using pre-packed syringes, modified with the tip removed.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4549236&req=5

pone.0136514.g004: Implantation of beads.Beads were implanted into individual implantation sites using pre-packed syringes, modified with the tip removed.

Mentions: For all 24 animals in the study, four implant sites were used per animal, two sites each side of the spine, in non-adjacent intramuscular sites (longissimus muscles) above the levels in L1-L2, L2-L3, L3-L4 and L4-L5 (Fig 3). The intermuscular plane between the multifidus and longissimus muscles was retracted to create a 1cm x 2cm void. The void was filled with approximately 1cc of test material, representing five beads of material per implant site. The beads were allocated in a sterile fashion into sterile 3cc syringes with the tip removed to facilitate implantation (Fig 4). This allowed uniform implantation and reproducible implantation. Each animal received CS beads in two sites and CSVT beads in the remaining two. The fascial incisions were closed with an individual single strand non-absorbable suture. Closure was achieved with equidistant adjacent stitches at approximately 3mm intervals. The skin of the incision was closed with an individual single strand absorbable suture in a continuous fashion. Animals were sacrificed in groups of four at 0, 1, 7, 21, 42, and 63 days post operatively.


Development of a Novel Model for the Assessment of Dead-Space Management in Soft Tissue.

Oliver RA, Lovric V, Yu Y, Christou C, Aiken SS, Cooper JJ, Walsh WR - PLoS ONE (2015)

Implantation of beads.Beads were implanted into individual implantation sites using pre-packed syringes, modified with the tip removed.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4549236&req=5

pone.0136514.g004: Implantation of beads.Beads were implanted into individual implantation sites using pre-packed syringes, modified with the tip removed.
Mentions: For all 24 animals in the study, four implant sites were used per animal, two sites each side of the spine, in non-adjacent intramuscular sites (longissimus muscles) above the levels in L1-L2, L2-L3, L3-L4 and L4-L5 (Fig 3). The intermuscular plane between the multifidus and longissimus muscles was retracted to create a 1cm x 2cm void. The void was filled with approximately 1cc of test material, representing five beads of material per implant site. The beads were allocated in a sterile fashion into sterile 3cc syringes with the tip removed to facilitate implantation (Fig 4). This allowed uniform implantation and reproducible implantation. Each animal received CS beads in two sites and CSVT beads in the remaining two. The fascial incisions were closed with an individual single strand non-absorbable suture. Closure was achieved with equidistant adjacent stitches at approximately 3mm intervals. The skin of the incision was closed with an individual single strand absorbable suture in a continuous fashion. Animals were sacrificed in groups of four at 0, 1, 7, 21, 42, and 63 days post operatively.

Bottom Line: Complete resorption was confirmed radiographically at 3 weeks post-implantation.Serological inflammatory cytokine expression for IL-6, TNF-α and IL-1β indicated no unusual inflammatory response to the implanted materials or surgical procedure.The two materials tested were effective in resolving the surgically created dead space, and did not elicit any unexpected adverse host response.

View Article: PubMed Central - PubMed

Affiliation: Surgical & Orthopaedic Research Laboratories, University of New South Wales Australia, Sydney, Australia, Prince of Wales Clinical School, Prince of Wales Hospital, Randwick, NSW, Australia.

ABSTRACT
Following extensive surgical debridement in the treatment of infection, a "dead space" can result following surgical closure that can fill with hematoma, an environment conducive to bacterial growth. The eradication of dead space is essential in order to prevent recurrent infection. This study describes a novel small animal model to investigate dead-space management in muscle tissue. Two absorbable test materials were implanted in each animal; beads of calcium sulfate alone, and beads loaded with vancomycin and tobramycin. In-life blood samples and radiographs were taken from each animal following implantation. Animals were sacrificed at 1, 7, 21, 42, and 63 days post-operatively (n = 4), and implant sites were analysed by micro-computed tomography, histology and immunohistochemistry. Complete resorption was confirmed radiographically at 3 weeks post-implantation. Histologically, the host tissue response to both materials was identical, and subsequent healing at the implant sites was observed with no dead space remaining. Vancomycin was not detected in blood serum. However, peak tobramycin levels were detected in all animals at 6 hours post-implantation with no detectable levels in any animals at 72 hours post implantation. Serological inflammatory cytokine expression for IL-6, TNF-α and IL-1β indicated no unusual inflammatory response to the implanted materials or surgical procedure. The model was found to be convenient and effective for the assessment of implant materials for management of dead space in muscle tissue. The two materials tested were effective in resolving the surgically created dead space, and did not elicit any unexpected adverse host response.

No MeSH data available.


Related in: MedlinePlus