Comparing various perioperative cleaning methods to eradicate biofilms commonly used orthopaedic implant materials - an in-vitro study

Zwols, T.L.R. (2015) Comparing various perioperative cleaning methods to eradicate biofilms commonly used orthopaedic implant materials - an in-vitro study. thesis, Medicine.

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Abstract

Background: In Western countries, life expectancy is increasing. With an increasing quantity of older people in society, degenerative diseases such as osteoarthritis will also become more frequent. In osteoarthritis, patients the cartilage becomes damaged and the patient experiences pain and inflammation symptoms in the joint. Often, this disease requires surgical intervention by means of removing the complete joint and implanting a prosthetic implant to provide a new, smooth surface. These surgeries are often without any complications. However, there is a chance of approximately 1-2% the prosthesis will become infected with a biofilm. This infection is hard to treat and it lengthens the period of time the patient is in the hospital. Often, a periprosthetic joint infection (PJI) leads to the removal of the implant, high-dose antibiotics and long hospitalization. A relatively new surgical approach in this situation is debridement surgery. In this surgery, the surgeon attempts to preserve primary implant by cleaning the implant and leaving it in the patient. However, the cleaning method varies among orthopaedic surgeons and the best strategy has not yet been established. Methods: In this in vitro study, we assessed the efficacy of mechanical and chemical components in removing biofilm: a medical brush, Philips Sonicare toothbrush, Oral-B electric toothbrush, povidone-iodine (1.35 g/L) and acetic acid (0.15%). A three day old biofilm of S. aureus ATCC 12600 is grown on a titanium or polyethylene disc (the same material as orthopaedic implants). After this, we tested every strategy including combinations. The amount of biofilm left on the disc was plated on agar plates in a dilution series and counted. Results: The bactericidal effect of acetic acid in this concentration showed no additive value in removing the biofilm. Povidone-iodine however, showed a synergetic effect with mechanical components, significantly improving the removal of biofilm when used together.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty supervisor: and Neut Dr. D. (UMCG) and Second supervisor: and Jutte, Dr. P.C. (UMCG) and Department of Biomedical Engineering, UMCG
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:55
Last Modified:	25 Jun 2020 10:55
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1560

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