多孔性アパタイトセラミックを用いた抗生剤徐放システムによる人工血管感染に対する保存的治療の実験的検討
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Objective : The purpose of this study is to investigate whether or not infection of the infected vascular graft could be treated by placing antibiotic-loaded porous apatite ceramic without removal of the infected graft. Methods : Teicoplanin (TEIC) as antibiotics were loaded into β-tricalcium phosphate block (TCP), which was one of the porous apatite ceramic. The graft was patched in the abdominal aorta of a rabbit, and then S. aureus was directly applied on it. Seven days after the operation, each rabbit underwent re-laparotomy and retroperitoneal abscess around the graft was underwent debridement (n=24). Animals were divided into the following groups. Group C was treated with debridement only. Group T40 and T60 received local irrigation with 40mg and 60mg of TEIC, respectively. In group B, antibiotic-loaded TCP included 63±6.6mg of TEIC was placed straddlingly around the graft. Three weeks after the second operation, the graft, the tissue around it and arterial blood were collected and cultivated. Results : Blood cultures were negative in all animals. The infection rates of the graft and the tissue around it were significantly lower in group B (0% ; 0/6) than in group C (83% ; 5/6) (p=0.03). Those were lower in group B than in Group T40 (50% ; 3/6) and T60 (50% ; 3/6). However, there were no statistically significant differences in infection rates between group B and T40 or T60. Conclusions : The slow-releasing system with an antibiotic-loaded TCP is useful for treatment of vascular graft infection without removing it.
- 岐阜大学の論文
- 2003-03-31
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