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Mirel S, Pusta A, Moldovan M, Moldovan S. Antimicrobial Meshes for Hernia Repair: Current Progress and Perspectives. J Clin Med 2022; 11:jcm11030883. [PMID: 35160332 PMCID: PMC8836564 DOI: 10.3390/jcm11030883] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 12/14/2022] Open
Abstract
Recent advances in the development of biomaterials have given rise to new options for surgery. New-generation medical devices can control chemical breakdown and resorption, prevent post-operative adhesion, and stimulate tissue regeneration. For the fabrication of medical devices, numerous biomaterials can be employed, including non-degradable biomaterials (silicone, polypropylene, expanded polytetrafluoroethylene) or biodegradable polymers, including implants and three-dimensional scaffolds for tissue engineering, which require particular physicochemical and biological properties. Based on the combination of new generation technologies and cell-based therapies, the biocompatible and bioactive properties of some of these medical products can lead to progress in the repair of injured or harmed tissue and in tissue regeneration. An important aspect in the use of these prosthetic devices is the associated infection risk, due to the medical complications and socio-economic impact. This paper provides the latest achievements in the field of antimicrobial surgical meshes for hernia repair and discusses the perspectives in the development of these innovative biomaterials.
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Affiliation(s)
- Simona Mirel
- Department of Medical Devices, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania;
| | - Alexandra Pusta
- Department of Medical Devices, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania;
- Correspondence:
| | - Mihaela Moldovan
- Pediatric Surgery Department, Emergency Clinical Children’s Hospital, 400370 Cluj-Napoca, Romania;
| | - Septimiu Moldovan
- Surgery Department, Prof. Dr. O. Fodor Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania;
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Viola GM, Rosenblatt J, Raad II. Drug eluting antimicrobial vascular catheters: Progress and promise. Adv Drug Deliv Rev 2017; 112:35-47. [PMID: 27496702 DOI: 10.1016/j.addr.2016.07.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/14/2016] [Accepted: 07/26/2016] [Indexed: 12/13/2022]
Abstract
Vascular catheters are critical tools in modern healthcare yet present substantial risks of serious bloodstream infections that exact significant health and economic burdens. Drug-eluting antimicrobial vascular catheters have become important tools in preventing catheter-related bloodstream infections and their importance is expected to increase as significant initiatives are expanded to eliminate and make the occurrence of these infections unacceptable. Here we review clinically significant and emerging drug-eluting antimicrobial catheters within the categories of antibiotic, antiseptic, novel bioactive agents and energy-enhanced drug eluting antimicrobial catheters. Important representatives of each category are reviewed from the standpoints of mechanisms of action, physical-chemical properties, safety, in vitro and clinical effectiveness.
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Affiliation(s)
- George M Viola
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Joel Rosenblatt
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Issam I Raad
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Majumder A, Scott JR, Novitsky YW. Evaluation of the Antimicrobial Efficacy of a Novel Rifampin/Minocycline-Coated, Noncrosslinked Porcine Acellular Dermal Matrix Compared With Uncoated Scaffolds for Soft Tissue Repair. Surg Innov 2016; 23:442-55. [PMID: 27354551 DOI: 10.1177/1553350616656280] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Despite meticulous aseptic technique and systemic antibiotics, bacterial colonization of mesh remains a critical issue in hernia repair. A novel minocycline/rifampin tyrosine-coated, noncrosslinked porcine acellular dermal matrix (XenMatrix AB) was developed to protect the device from microbial colonization for up to 7 days. The objective of this study was to evaluate the in vitro and in vivo antimicrobial efficacy of this device against clinically isolated methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli. Methods XenMatrix AB was compared with 5 existing uncoated soft tissue repair devices using in vitro methods of zone of inhibition (ZOI) and scanning electron microscopy (SEM) at 24 hours following inoculation with MRSA or E coli These devices were also evaluated at 7 days following dorsal implantation and inoculation with MRSA or E coli (60 male New Zealand white rabbits, n = 10 per group) for viable colony-forming units (CFU), abscess formation and histopathologic response, respectively. Results In vitro studies demonstrated a median ZOI of 36 mm for MRSA and 16 mm for E coli for XenMatrix AB, while all uncoated devices showed no inhibition of bacterial growth (0 mm). SEM also demonstrated no visual evidence of MRSA or E coli colonization on the surface of XenMatrix AB compared with colonization of all other uncoated devices. In vivo XenMatrix AB demonstrated complete inhibition of bacterial colonization, no abscess formation, and a reduced inflammatory response compared with uncoated devices. Conclusion We demonstrated that XenMatrix AB possesses potent in vitro and in vivo antimicrobial efficacy against clinically isolated MRSA and E coli compared with uncoated devices.
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Affiliation(s)
- Arnab Majumder
- University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Jeffrey R Scott
- Brown University, Providence, RI, USA C. R. Bard, Inc (Davol), Warwick, RI, USA
| | - Yuri W Novitsky
- University Hospitals Case Medical Center, Cleveland, OH, USA
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Rastegarpour A, Cheung M, Vardhan M, Ibrahim MM, Butler CE, Levinson H. Surgical mesh for ventral incisional hernia repairs: Understanding mesh design. Plast Surg (Oakv) 2016; 24:41-50. [PMID: 27054138 DOI: 10.4172/plastic-surgery.1000955] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Surgical mesh has become an indispensable tool in hernia repair to improve outcomes and reduce costs; however, efforts are constantly being undertaken in mesh development to overcome postoperative complications. Common complications include infection, pain, adhesions, mesh extrusion and hernia recurrence. Reducing the complications of mesh implantation is of utmost importance given that hernias occur in hundreds of thousands of patients per year in the United States. In the present review, the authors present the different types of hernia meshes, discuss the key properties of mesh design, and demonstrate how each design element affects performance and complications. The present article will provide a basis for surgeons to understand which mesh to choose for patient care and why, and will explain the important technological aspects that will continue to evolve over the ensuing years.
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Affiliation(s)
- Ali Rastegarpour
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center
| | - Michael Cheung
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center
| | - Madhurima Vardhan
- Department of Biomedical Engineering, Duke University, Pratt School of Engineering, Durham, North Carolina
| | - Mohamed M Ibrahim
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center
| | - Charles E Butler
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Howard Levinson
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center
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Rastegarpour A, Cheung M, Vardhan M, Ibrahim MM, Butler CE, Levinson H. Surgical mesh for ventral incisional hernia repairs: Understanding mesh design. Plast Surg (Oakv) 2016. [DOI: 10.1177/229255031602400110] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Surgical mesh has become an indispensable tool in hernia repair to improve outcomes and reduce costs; however, efforts are constantly being undertaken in mesh development to overcome postoperative complications. Common complications include infection, pain, adhesions, mesh extrusion and hernia recurrence. Reducing the complications of mesh implantation is of utmost importance given that hernias occur in hundreds of thousands of patients per year in the United States. In the present review, the authors present the different types of hernia meshes, discuss the key properties of mesh design, and demonstrate how each design element affects performance and complications. The present article will provide a basis for surgeons to understand which mesh to choose for patient care and why, and will explain the important technological aspects that will continue to evolve over the ensuing years.
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Affiliation(s)
- Ali Rastegarpour
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Michael Cheung
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Madhurima Vardhan
- Department of Biomedical Engineering, Duke University, Pratt School of Engineering, Durham, North Carolina
| | - Mohamed M Ibrahim
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Charles E Butler
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Howard Levinson
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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Guillaume O, Teuschl AH, Gruber-Blum S, Fortelny RH, Redl H, Petter-Puchner A. Emerging Trends in Abdominal Wall Reinforcement: Bringing Bio-Functionality to Meshes. Adv Healthc Mater 2015; 4:1763-89. [PMID: 26111309 DOI: 10.1002/adhm.201500201] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 05/12/2015] [Indexed: 12/19/2022]
Abstract
Abdominal wall hernia is a recurrent issue world-wide and requires the implantation of over 1 million meshes per year. Because permanent meshes such as polypropylene and polyester are not free of complications after implantation, many mesh modifications and new functionalities have been investigated over the last decade. Indeed, mesh optimization is the focus of intense development and the biomaterials utilized are now envisioned as being bioactive substrates that trigger various physiological processes in order to prevent complications and to promote tissue integration. In this context, it is of paramount interest to review the most relevant bio-functionalities being brought to new meshes and to open new avenues for the innovative development of the next generation of meshes with enhanced properties for functional abdominal wall hernia repair.
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Affiliation(s)
- Olivier Guillaume
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Donaueschingenstraße 13 A-1200 Vienna Austria
- Austrian Cluster for Tissue Regeneration; Donaueschingenstrasse 13 A-1200 Vienna Austria
| | - Andreas Herbert Teuschl
- Austrian Cluster for Tissue Regeneration; Donaueschingenstrasse 13 A-1200 Vienna Austria
- University of Applied Sciences Technikum Wien; Department of Biochemical Engineering; Höchstädtplatz 5 1200 Vienna Austria
| | - Simone Gruber-Blum
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Donaueschingenstraße 13 A-1200 Vienna Austria
- Austrian Cluster for Tissue Regeneration; Donaueschingenstrasse 13 A-1200 Vienna Austria
- Department of General Visceral and Oncological Surgery; Wilhelminenspital der Stadt Wien; Montleartstraße 37 A-1171 Vienna Austria
| | - René Hartmann Fortelny
- Austrian Cluster for Tissue Regeneration; Donaueschingenstrasse 13 A-1200 Vienna Austria
- Department of General Visceral and Oncological Surgery; Wilhelminenspital der Stadt Wien; Montleartstraße 37 A-1171 Vienna Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Donaueschingenstraße 13 A-1200 Vienna Austria
- Austrian Cluster for Tissue Regeneration; Donaueschingenstrasse 13 A-1200 Vienna Austria
| | - Alexander Petter-Puchner
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Donaueschingenstraße 13 A-1200 Vienna Austria
- Austrian Cluster for Tissue Regeneration; Donaueschingenstrasse 13 A-1200 Vienna Austria
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Udpa N, Iyer SR, Rajoria R, Breyer KE, Valentine H, Singh B, McDonough SP, Brown BN, Bonassar LJ, Gao Y. Effects of chitosan coatings on polypropylene mesh for implantation in a rat abdominal wall model. Tissue Eng Part A 2013; 19:2713-23. [PMID: 23859182 DOI: 10.1089/ten.tea.2012.0739] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Hernia repair and pelvic floor reconstruction are usually accompanied with the implantation of a surgical mesh, which frequently results in a foreign body response with associated complications. An ideal surgical mesh that allows force generation of muscle tissues without significant granulation tissue and/or fibrosis is of significant clinical interest. The objective of the present study was to evaluate the in vitro and in vivo responses of a chitosan coating on polypropylene mesh (Ch-PPM) in comparison with commercially available meshes. We found that application of a 0.5% (w/v) Ch-PPM elicited preferential attachment of myoblasts over fibroblast attachment in vitro. Therefore, we test the hypothesis that 0.5% Ch-PPM will encourage skeletal muscle tissue ingrowth and decrease fibrosis formation in vivo. We implanted 0.5% Ch-PPM, collagen-coated polypropylene mesh (Pelvitex™; C.R. Bard), and polypropylene (Avaulta Solo(®); C.R. Bard) alone using a rat abdominal defect model. Force generation capacity and inflammatory response of each mesh were evaluated 2, 4, and 12 weeks postimplantation. We found that chitosan coating is associated with the restoration of functional skeletal muscle with histomorphologic characteristics that resemble native muscle and an early macrophage phenotypic response that has previously been shown to lead to more functional outcomes.
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Affiliation(s)
- Natasha Udpa
- 1 Sibley School of Mechanical and Aerospace Engineering, Cornell University , Ithaca, New York
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Mavros MN, Athanasiou S, Alexiou VG, Mitsikostas PK, Peppas G, Falagas ME. Risk factors for mesh-related infections after hernia repair surgery: a meta-analysis of cohort studies. World J Surg 2012; 35:2389-98. [PMID: 21913136 DOI: 10.1007/s00268-011-1266-5] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Mesh infection, although infrequent, is a devastating complication of mesh hernioplasties. The aim of this study was to systematically review and synthesize the available evidence on risk factors for synthetic mesh infection after hernioplasty. A systematic search was performed in PubMed and Scopus databases. The extracted data were synthesized with the methodology of meta-analysis. We identified six eligible studies that reported on 2,418 mesh hernioplasties. The crude mesh infection rate was 5%. Statistically significant risk factors were smoking (risk ratio [RR] = 1.36 [95% confidence interval (CI): 1.07, 1.73]; 1,171 hernioplasties), American Society of Anesthesiologists (ASA) score ≥3 (RR = 1.40 [1.15, 1.70]; 1,682 hernioplasties), and emergency operation (RR = 2.46 [1.56, 3.91]; 1,561 hernioplasties). Also, mesh infections were significantly correlated with patient age (weighted mean difference [WMD] = 2.63 [0.22, 5.04]; 2,364 hernioplasties), ASA score (WMD = 0.23 [0.08, 0.38]; 1,682 hernioplasties), and the duration of the hernioplasty (WMD = 44.92 [25.66, 64.18]; 833 hernioplasties). A trend toward higher mesh infection rates was observed in obese patients (RR = 1.41 [0.94, 2.11]; 2,243 hernioplasties) and in patients operated on by a resident (in contrast to a consultant; RR = 1.18 [0.99, 1.40]; 982 hernioplasties). Mesh infections usually resulted in mesh removal, and common pathogens included Staphylococcus spp., Enterococcus spp., and gram-negative bacteria. Patient age, ASA score, smoking, and the duration and emergency setting of the operation were found to be associated with the development of synthetic mesh infection. The heterogeneity of the available evidence should be taken under consideration. Prospective studies with a meticulous follow-up are warranted to further investigate mesh-related infections.
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Affiliation(s)
- Michael N Mavros
- Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23, Marousi, Athens, Greece
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Klink CD, Binnebösel M, Lambertz A, Alizai HP, Roeth A, Otto J, Klinge U, Neumann UP, Junge K. In vitro and in vivo characteristics of gentamicin-supplemented polyvinylidenfluoride mesh materials. J Biomed Mater Res A 2012; 100:1195-202. [DOI: 10.1002/jbm.a.34066] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 08/22/2011] [Accepted: 10/21/2011] [Indexed: 11/07/2022]
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Abstract
AbstractVitronectin (Vn) is a multifunctional glycoprotein profusely present in serum and bound to epithelial cell surfaces. It plays an important role in cell migration, tissue repair and regulation of membrane attack complex (MAC) formation. In the last decade the role of Vn has been extensively investigated in eukaryotic signalling and cell migration leading to the possibility of developing novel anticancer drugs. In parallel, several studies have suggested that pathogens utilize Vn in invasion of the host. Here we review the properties of Vn and its role in host-pathogen interactions that might be a future target for therapeutic intervention.
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New antibiotic-eluting mesh used for soft tissue reinforcement. Acta Biomater 2011; 7:3390-7. [PMID: 21621016 DOI: 10.1016/j.actbio.2011.05.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 04/27/2011] [Accepted: 05/09/2011] [Indexed: 11/23/2022]
Abstract
The surgical implantation of prostheses for soft tissue repair may be followed by post-operative mesh-related infection, a significant and dramatic complication, that is treated by mesh removal. A new antibiotic-eluting mesh has been manufactured on pre-existing polypropylene prostheses using an airbrush spraying technology. Among the degradable polymers tested as coating agents and drug reservoirs, poly(ε-caprolactone) (PCL), which is deposited after heating, provides a homogeneous, regular and smooth shell around the polypropylene filaments of the mesh without dramatically altering the biomechanical properties of the new modified mesh. An anti-infective drug (e.g. ofloxacin) is incorporated into this polymeric coating giving a limited burst effect followed by sustained drug diffusion for several days. An ofloxacin-eluting mesh has demonstrated excellent antibacterial activity in vitro on Escherichia coli adherence, biofilm formation and inhibitory diameter, even with low drug loads. Although further in vivo investigations are required to draw conclusions on the anti-infective effectiveness of the coated mesh, the airbrush coating of ofloxacin-PCL on existing prostheses is already potentially appealing in an effort to decrease post-operative infection.
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Laurent T, Kacem I, Blanchemain N, Cazaux F, Neut C, Hildebrand H, Martel B. Cyclodextrin and maltodextrin finishing of a polypropylene abdominal wall implant for the prolonged delivery of ciprofloxacin. Acta Biomater 2011; 7:3141-9. [PMID: 21569872 DOI: 10.1016/j.actbio.2011.04.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 04/08/2011] [Accepted: 04/22/2011] [Indexed: 10/18/2022]
Abstract
The aim of this work was to develop a polypropylene (PP) artificial abdominal wall implant for the prolonged release of ciprofloxacin (CFX). This sustained release effect was obtained by functionalization of the textile mesh with citric acid and hydroxypropyl-γ-cyclodextrin (HPγCD) or maltodextrin (MD). In both cases the textile finishing reaction yielded a cyclo- or malto-dextrin crosslinked polymer coating the fibers. The modified supports were characterized by thermogravimetric analysis (TGA), differential scanning calorimetry and scanning electron microscopy. The sorption capacities and the kinetics of CFX release were studied by batch tests coupled with spectrophotometric assays. Microbiological assays were carried out on Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli, while proliferation and viability tests used fibroblasts. The main results were as follows. (i) Due to the differences between the range of temperature of thermal degradation of the (cyclo)dextrins polymers and of the PP fibers TGA was a reliable method for quantifying the degree of functionalization of the textiles. (ii) Both modified supports showed improved sorption/desorption capacities for CFX, compared with the virgin mesh. The HPγCD-finished support showed an increased sorption capacity and a lower release rate of CFX compared with the MD modified support. (iii) Microbiological assays confirmed the latter result, with greater sustained antibacterial activity of the HPγCD treated support. These experiments have demonstrated the role of the cyclodextrin cavity in interactions with CFX: the antibiotic was not only adsorbed via hydrogen and acid-base interactions with the polyCTR-HPγCD network, but also via host-guest complexation. (iv) Biological tests revealed a slight decrease in fibroblast proliferation after 6 days on the modified supports, but cell viability tests showed that this was not due to toxicity of the (cyclo)dextrin polymer coatings.
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Covalent immobilization of antimicrobial peptides (AMPs) onto biomaterial surfaces. Acta Biomater 2011; 7:1431-40. [PMID: 21056701 DOI: 10.1016/j.actbio.2010.11.005] [Citation(s) in RCA: 371] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 10/05/2010] [Accepted: 11/01/2010] [Indexed: 11/22/2022]
Abstract
Bacterial adhesion to biomaterials remains a major problem in the medical devices field. Antimicrobial peptides (AMPs) are well-known components of the innate immune system that can be applied to overcome biofilm-associated infections. Their relevance has been increasing as a practical alternative to conventional antibiotics, which are declining in effectiveness. The recent interest focused on these peptides can be explained by a group of special features, including a wide spectrum of activity, high efficacy at very low concentrations, target specificity, anti-endotoxin activity, synergistic action with classical antibiotics, and low propensity for developing resistance. Therefore, the development of an antimicrobial coating with such properties would be worthwhile. The immobilization of AMPs onto a biomaterial surface has further advantages as it also helps to circumvent AMPs' potential limitations, such as short half-life and cytotoxicity associated with higher concentrations of soluble peptides. The studies discussed in the current review report on the impact of covalent immobilization of AMPs onto surfaces through different chemical coupling strategies, length of spacers, and peptide orientation and concentration. The overall results suggest that immobilized AMPs may be effective in the prevention of biofilm formation by reduction of microorganism survival post-contact with the coated biomaterial. Minimal cytotoxicity and long-term stability profiles were obtained by optimizing immobilization parameters, indicating a promising potential for the use of immobilized AMPs in clinical applications. On the other hand, the effects of tethering on mechanisms of action of AMPs have not yet been fully elucidated. Therefore, further studies are recommended to explore the real potential of immobilized AMPs in health applications as antimicrobial coatings of medical devices.
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The use of infection prevention practices in female pelvic medicine and reconstructive surgery. Curr Opin Obstet Gynecol 2010; 22:408-13. [DOI: 10.1097/gco.0b013e32833e49c3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Çakmak A, Çirpanli Y, Bilensoy E, Yorganci K, Çaliş S, Saribaş Z, Kaynaroğlu V. Antibacterial activity of triclosan chitosan coated graft on hernia graft infection model. Int J Pharm 2009; 381:214-9. [DOI: 10.1016/j.ijpharm.2009.05.059] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Revised: 04/20/2009] [Accepted: 05/26/2009] [Indexed: 11/26/2022]
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