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Biomedical subjects

V Leflon

Publications and source records attributed to V Leflon.

4 recordsLinked to original sources

Experimental treatment of vascular graft infection due to Staphylococcus epidermidis by in situ replacement with a rifampin-bonded polyester graft.

In situ prosthetic graft replacement (ISPGR) of an infected prosthesis raises the risk of recurrent infection in the new graft, especially in cases involving drug-resistant microorganisms. The purpose of this animal study was to evaluate in situ replacement of a vascular graft infected by a highly rifampin-resistant strain of Staphylococcus epidermidis with the use of a rifampin-bonded polyester graft. Antibiotic bonding was obtained by soaking grafts in a high dose of rifampin solution (60 mg/mL). The infrarenal abdominal aorta of 20 dogs was replaced using a polyester prosthesis infected with a highly rifampin-resistant strain of Staphylococcus epidermidis. One week later, the 18 surviving animals were randomized into three groups. Group I (n = 6) did not undergo reoperation. Group II (n = 6) underwent ISPGR using a rifampin-bonded prosthesis. Group III (n = 6) underwent ISPGR using an untreated prosthesis. All surviving animals were killed 28 days after the first procedure. Infectious signs were noted and bacteriological study was carried out on explanted prostheses and various tissue samples. The findings of this experimental study show that soaking a polyester prosthesis in a high-dose rifampin solution can prevent reinfection after in situ replacement of a prosthesis infected by a highly rifampin-resistant Staphylococcus epidermidis.

Anastomosis, Surgical↗

Resistance of antibiotic-bonded gelatin-coated polymer meshes to Staphylococcus aureus in a rabbit subcutaneous pouch model.

This study examines the efficacy of the bonding of rifampicin, vancomycin or gentamicin to gelatin-coated knitted polymer meshes to prevent perioperative infection. Antibiotic bonding was obtained by soaking the meshes for 15 min in a solution containing 20 mg ml(-1) of rifampicin or 10 mg ml(-1) of vancomycin or gentamicin. A polymer mesh was implanted in a subcutaneous pouch in 16 rabbits: four received a rifampicin-soaked mesh, four received a vancomycin-soaked mesh, four received a gentamicin-soaked mesh, and four received an untreated mesh (control group). At the time of implantation, all the meshes were contaminated locally with 10(8) colony forming units of Staphylococcus aureus. Meshes were harvested one week later and submitted to bacterial counts. At the time of explantation, none of the antibiotic-soaked meshes were infected, whereas all the untreated meshes were infected. These results show that antibiotic soaking evidently prevents perioperative infection of gelatin-coated knitted polymer meshes in this model.

Animals↗

Treatment of vascular graft infection by in situ replacement with cryopreserved aortic allografts: an experimental study.

PURPOSE: The purposes of this study were to prove the efficacy of cryopreserved aortic allografts to treat an established vascular graft infection by in situ replacement in an animal model and to evaluate the role of the antibiotics normally used to decontaminate the allografts. METHODS: Twenty-three dogs underwent infrarenal aortic replacement with a gelatin-sealed knitted polyester graft contaminated in vitro by Staphylococcus epidermidis RP-62. One week later, the 18 surviving animals underwent reoperation for graft removal and were randomized into three groups for in situ replacement: group I (control, n = 6) received a new gelatin-sealed graft; group II (n = 6) received a non-antibiotic-treated cryopreserved allograft; and group III (n = 6) received an antibiotic-treated cryopreserved allograft. Control grafts and allografts were removed 4 weeks after the initial intervention for quantitative bacteriologic analysis and histologic analysis. Bacteriologic results were expressed as colony-forming units per square centimeter of graft material. Qualitative bacteriologic analysis was also obtained from perigraft fluid and tissue. RESULTS: All of the initially implanted grafts and all of the control grafts (group I) were infected at the time of removal. In group II, three out of six allografts were not totally incorporated, whereas in group III incorporation was always complete, with a significantly decreased inflammatory reaction. All of the antibiotic-treated allografts were sterile, whereas three untreated allografts grew bacteria. CONCLUSIONS: In this model, cryopreserved aortic allografts were more resistant to reinfection than synthetic grafts after in situ replacement of an infected prosthetic graft. However, the antibiotic loading of the cryopreserved aortic allograft appears to be essential to obtain optimal therapeutic effects.

Animals↗