The effectiviness of impregnation of graft with cefazolin in foreign body infection

Abstract number: p839

Kilic  D., Agalar  C., Denkbas  E., Agalar  F., Ozturk  E., Emirdogan   M., Deveci  O.

Objective: 

Foreign body infection (FBI) is a real problem in clinical situations. In the present study, in vitro and in vivo efficiacy of impraganation of mesh with cefazolin in prevention of FBI.

Materials and methods: 

Strain: The microorganism was slime positive, methicillin-resistant S. epidermidis (MRSE). Impregnation: Cefazolin impregnated grafts were prepared by dipping method. Naive meshes, in size of 5 × 10 mm were immersed into the polylactic acid (PLA) solution in dichlorometahane including cefazolin with different concentrations (i.e., 0.025, 0.05 and 0.3 g sefazolin/5 ml and 2% w/v of PLA solution). Cefazolin impregnated and naive grafts with different concentration (Group 1 = 0.025 g, Group 2 = 0.05 g, and Group 3 = 0.3 g) were incubated with 108 cfu/ml slime positive MRSE. In vitro: After 24 and 48 hours of incubation, the numbers of colonies were counted in an aliquot and adhered to catheter. In vivo: Contaminated naïve and cefazolin-impregnated grafts (n = 10 in each groups) were implanted subcutaneously in the back of Swiss albino mouse. Grafts were explanted at 7 days following implantation. Microbiologic assessments and electron microscopic (JOEL JSM-5600 Japan) evaluation of catheter segments were performed.

Results: 

Impregnation of cefazolin decreased the numbers of adherent bacteria to the grafts and the number of free bacteria within the liquid medium significantly in all groups. In all comparisons; the decrease of bacterial counts were statistically significant, except the values at 48 hours of group 2 vs group 3. Cfu counts in explanted grafts were significantly less in treatment than in control group and wound infection rates also decreased, accordingly.

Conclusions: 

Impregnation of cefazolin to grafts by dipping method may protect against FBI with MRSE during peri-operative period.