| Objective: Infection is a thorny issues for the present surgeon. The treatment of bone infection for Open fractures and orthopaedic surgery is the present major challenges for orthopedist.The complications of Bone infection causing significant impact in patients with the economy and physical . The serious complications lead to permanent disability or even loss of life. Previous studies of bone infection for people treatment more than prevention, and made some clinical achievements, but its treatment of long-term and disabling problems still exist in reality. Along with the development of medicine, increased understanding of the etiology, prevention of infection of the bone ensuing increase, and achieved certain results, and the application of antibiotics as a preventive bone infection as a key factor , but also to change from the original after operation to preoperative medication,from the previous systemic high-dose medication gradually to the current changes advocated by the local medication. Along with the continuous progress of research, the present study to find a drug carrier.It can release antibiotic in the partial of the long-term to kill bacteria and prevent infection. The carrier can be autologous degradation, again without removed surgery,reduce the pain of patients and does not affect fracture and skin healing. The use of calcium alginate gelatin which is a perfect tissue engineering bracket material in repairing of orthopaedics wound is a hotspot at the research of tissue engineering .It is used widely at pharmacy ,foodstuff, bioengineering material because it can be slow absorption, chemical stability, low toxicity, heat to low, immune response. Especially as carrier sustained-release drug carrier is focus for the current to study. In this paper, through the application of calcium alginate gel compound vancomycin compares with Tricalcium phosphate (TCP) compound antibiotics and traditional systemic antibiotic drug treatment,through modeling osteomyelitis, compared preoperative and postoperative weight, body temperature, the changes in WBC and the modeling X-ray, pathology, the cultivation of bacteria to study the effect with local drug delivery system of administration to the prevention of bone infection.Methods:In this Experimental studis, 60 healthy adult New Zealand white rabbits for the experiment were randomly divided into three groups: group A, group B and group C, each group of 20, each group were established osteomyelitis model in right tibiae with Staphylococcus aureus . After making osteomyelitis model,group A was closed incision for five days vancomycin injection, group B received TCP compound vancomycin implant before incision closed,calcium alginate gel compound vancomycin implant local in group C. Each group were observed body temperature,the WBC changes and weights at 2nd,3th, 4th, 6th and 8th week after operations,compared with the preoperative and observed the changes of postoperative in the general group. Six rabbits were killed randomly and weighted at 4 and 8 weeks . Through the weight of postoperative compared with the preoperative and observe radiology, pathology,bacteriological examination after operation .All the data will be collected for statistical analysis and compare the effect for prevent bone infection .Results :In group A one rabbit died at 3 days after operation,the mortality rate is 5%. Group B and Group C without rabbits died. Gross observation : 14 rabbits In group A and 9 rabbits in group B had local swelling and partial sinus. Purulent secretion was find in group A and in group B rabbits incision after executed. In group C ,the wound healed well,and no purulent secretion was find in incision. Result observation of temperature and WBC : It was obvious statistical significance in group A and group B compared with the preoperative at 2nd,3th weeks after operation . Without statistical significance after 4 weeks postoperative . The temperature of Group A and Group B at 2, 3 weeks after operation higher than group C, it has statistical significance. It has not statistically significant after the four weeks in group A and group B compare with group C . There are obvious difference of body weight in group A and group B at 4th and 8th weeks postoperation compared with the preoperative. Temperature and WBC result of postoperation non-statistics significance in Group C compared with preoperative. 19 rabbits bacterial culture is positive in group A and the positive rate for bacterial culture was 100%. 10 rabbits bacterial culture is positive in group B and the positive rate for bacterial culture was 50%. In group C the positive rate for bacterial culture was 0.In group A the radiologically Laurence scoring for osteomyelitis gave by far the biggest among all 3 groups. In the group B the radiologically Laurence scoring for osteomyelitis bigger than group C . The rate for bacteria detection positive in group B without statistical significance compare with group A. The Laurence scoring for osteomyelitis in group A have statistical significance compare with group B and group C(P<0.05).Histological examinations of group A and group B find the massive lymphocytes as well as dead bone . In group C no evidence of Osteomyelitis found in gross and histological examinations.Conclusion :The calcium alginate gel is a delayed release carrier and capable of slowly delivering antibiotic at local and Forms the high concentration in the part to kill bacteria . calcium alginate gel compound vancomycin has strong anti-infection ability and prevent infection. It can apply in clinical and set it surrounding the internal fixation and operating field at orthopedics operation to achieve the aim prevent bone infection... |
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