Osteosynthesis and Trauma Care 2004; 12(2): 77-80
DOI: 10.1055/s-2004-822683
Original Article

© Georg Thieme Verlag Stuttgart · New York

Prevention of Pin Tract Infections in Goats Using Antibiotic Coated Polyurethane Tubing

B. J. Rosenberg1 , S. Durrani2 , J. S. Madsen3 , D. Seligson1
  • 1Fracture Service, Department of Orthopaedics, University of Louisville, Louisville, KY, USA
  • 2Küntscher Fellow, University of Louisville, Louisville, KY, USA
  • 3Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA
Further Information

Publication History

Publication Date:
05 July 2004 (online)

Abstract

Pin tract infections have been considered a major drawback in the use of external fixation and can deleteriously affect bone and soft tissue healing. Recognizing the scope of the problem, a study was designed to evaluate the efficacy of antibiotic-impregnated polyurethane tubing for the prevention of pin tract infections. Antibiotic-coated pin sleeves were manufactured by Smith & Nephew, Richards, Memphis, TN and were made of polyether-based, thermoplastic polyurethane tubing, which is the same material used in cardiovascular and urological catheters and stents. The interior and exterior of the tubing were coated with an antibiotic polymer matrix (gentamicin 0.2 to 0.4 mg/cm2) from which the antibiotic was released. 4-mm half-pins were placed in the iliac crest of goats and randomly assigned pins were then treated with the antibiotic sleeve. Pins were contaminated with a gentamicin-sensitive strain of Staphylococcus aureus. The antibiotic-loaded pin sleeves were effective in decreasing the number of organism colony forming units per pin by 4 orders of magnitude (P < 0.005) and increasing the stability of the external half pins by 24.5 % (P < 0.05).

References

  • 1 Anderson L D, Hutchinson W C, Wright P E, Disney J M. Fractures of the tibia and fibula treated by casts and transfixing pins.  Clin Orthop. 1974;  105 179-191
  • 2 Arens S, Schlegel U, Printzen G, Ziegler W J, Perren S M, Hansis M. Influence of materials for fixation implants on local infection. An experimental study of steel versus titanium DCP in rabbits.  J Bone Joint Surg [Br]. 1996;  78 647-651
  • 3 Behrens F. External skeletal fixation, part H.  Instructional Course Lectures. 1981;  30 170-182
  • 4 Behrens F, Searls K. External fixation of the tibia. Basic concepts and prospective evaluation.  J Bone Joint Surg [Br]. 1986;  68 246-254
  • 5 Burny F. Complications liées a l'utilization de l'osteotaxis.  Acta orthopaedic Belg. 1975;  41 103-109
  • 6 Caja V L, Moroni A. Hydroxyapatite coated external fixation pins: an experimental study.  Clin Orthop. 1996;  325 269-275
  • 7 Collinge C A, Goll G, Seligson D, Easley K J. Pin tract infections: silver vs uncoated pins.  Orthopedics. 1994;  17 445-448
  • 8 Colmano G, Edwards S S, Barranco S D. Activated silver coatings for surgical implants.  Va Med. 1979;  106 928-930
  • 9 Green S A. Complications of external fixation.  Clinical Orthopaedics. 1983;  180 109-116
  • 10 Lund M E, Hawkinson R W. Evaluation of the prompt inoculation system for preparation for standardized bacterial inocula.  J Clin Microbiology. 1983;  18 84-91
  • 11 Mahan J, Seligson D, Henry S L, Hynes P, Dobbins J. Factors in pin tract infections.  Orthopedics. 1991;  14 305-308
  • 12 Mathews L S, Green S A, Goldstein S A. The thermal effects of skeleton fixation-pin insertion into the bone.  J Bone Joint Surg [Am]. 1984;  66 1017-1083
  • 13 McGraw J M, Lim E V. Treatment of open tibial-shaft fractures: External fixation and secondary intramedullary nailing.  J Bone Joint Surg [Am]. 1988;  70 900-911
  • 14 Moroni A, Aspenberg P, Toksvig-Larsen S, Falzarano G, Giannini S. Enhanced fixation with hydroxyapatite coated pins.  Clin Orthop. 1998;  346 171-177
  • 15 Moroni A, Toksvig-Larsen S, Maltarello M C, Orienti L, Stea S, Giannini S. A comparison of hydroxyapatite-coated, titanium-coated, and uncoated tapered external-fixation pins. An in vivo study in sheep.  J Bone Joint Surg [Am]. 1998;  80 547-554
  • 16 Raiha J, Granholm S, Rinkinen M, Miettinen S, Tormala P. Effect of slow release antibiotics on pin-tract infection.  Tijdschr Diergeneeskd. 1993;  118 (Suppl 1) 18 S
  • 17 Respet P J, Kliemann P G, Meinhard B P. Pin tract infections: a canine model.  J Orthopaedic Research. 1987;  5 600-603
  • 18 Rohan N J, Wallace M E. Pin tract osteomyelitis.  Southern Medical Journal. 1969;  62 1316-1319
  • 19 Steinfeld P H, Cobelli N J, Sadler A H, Szporn M N. Open tibial fractures treated by anterior half-pin frame fixation.  Clinical Orthopaedics. 1988;  228 208-214
  • 20 Voos K, Rosenberg B, Fagrhi M, Seligson D. The use of a tobramycin-impregnated polymethylmethacrylate pin sleeve for the prevention of pin tract infection in goats.  J Orthopedic Trauma. 1999;  13 98-101
  • 21 Wassall M A, Santin M, Isalberti C, Cannas M, Denyer S P. Adhesion of bacteria to stainless steel and silver-coated orthopedic external fixation pins.  J Biomed Mater Res. 1997;  36 325-330
  • 22 WHO .Expert Committee on Biological Standardization. WHO Tech Rep Ser 610; 1977

David SeligsonMD, Professor 

Department of Orthopaedics · University of Louisville

550 South Jackson St. 3rd Floor Bridge

Louisville, KY 40202

USA

Phone: Phone: +1/5 02-8 52-09 23

Fax: +1/5 02-8 52-89 51

Email: Seligson@louisville.edu; Josh.madsen@louisville.edu

    >