The risk of biomaterial-associated infection after revision surgery due to an experimental primary implant infection

Anton F. Engelsman Department of BioMedical Engineering, University Medical Center Groningen and University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands; Department of Surgery, University Medical Center Groningen and University of Groningen, P. Box 196, 9700 AD Groningen, The Netherlands

Isabel C. Saldarriaga-Fernandez Department of BioMedical Engineering, University Medical Center Groningen and University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands

M. Reza Nejadnik Department of BioMedical Engineering, University Medical Center Groningen and University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands

Gooitzen M. van Dam Department of Surgery, University Medical Center Groningen and University of Groningen, P. Box 196, 9700 AD Groningen, The Netherlands; BioOptical Imaging Center Groningen, University Medical Center Groningen and University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands

Kevin P. Francis Department of Surgery, University Medical Center Groningen and University of Groningen, P. Box 196, 9700 AD Groningen, The Netherlands; BioOptical Imaging Center Groningen, University Medical Center Groningen and University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands

Rutger J. Ploeg Department of Surgery, University Medical Center Groningen and University of Groningen, P. Box 196, 9700 AD Groningen, The Netherlands

Henk J. Busscher Department of BioMedical Engineering, University Medical Center Groningen and University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands

Henny C. van der Mei Department of BioMedical Engineering, University Medical Center Groningen and University of Groningen, PO Box 196, 9700 AD Groningen, The NetherlandsCorrespondence[email protected]

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Abstract

The fate of secondary biomaterial implants was determined by bio-optical imaging and plate counting, after antibiotic treatment of biomaterials-associated-infection (BAI) and surgical removal of an experimentally infected, primary implant. All primary implants and tissue samples from control mice showed bioluminescence and were culture-positive. In an antibiotic treated group, no bioluminescence was detected and only 20% of all primary implants and no tissue samples were culture-positive. After revision surgery, bioluminescence was detected in all control mice. All the implants and 80% of all tissue samples were culture-positive. In contrast, in the antibiotic treated group, 17% of all secondary implants and 33% of all tissue samples were culture-positive, despite antibiotic treatment. The study illustrates that due to the BAI of a primary implant, the infection risk of biomaterial implants is higher in revision surgery than in primary surgery, emphasizing the need for full clearance of the infection, as well as from surrounding tissues prior to implantation of a secondary implant.

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The risk of biomaterial-associated infection after revision surgery due to an experimental primary implant infection

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The risk of biomaterial-associated infection after revision surgery due to an experimental primary implant infection

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