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Journal of Orthopaedics and Traumatology
Published in: Journal of Orthopaedics and Traumatology 2/2017

Open Access 01-06-2017 | Original Article

Fast-resorbable antibiotic-loaded hydrogel coating to reduce post-surgical infection after internal osteosynthesis: a multicenter randomized controlled trial

Authors: Kostantinos Malizos, Michael Blauth, Adrian Danita, Nicola Capuano, Riccardo Mezzoprete, Nicola Logoluso, Lorenzo Drago, Carlo Luca Romanò

Published in: Journal of Orthopaedics and Traumatology | Issue 2/2017

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Abstract

Background

Infection is one of the main reasons for failure of orthopedic implants. Antibacterial coatings may prevent bacterial adhesion and biofilm formation, according to various preclinical studies. The aim of the present study is to report the first clinical trial on an antibiotic-loaded fast-resorbable hydrogel coating (Defensive Antibacterial Coating, DAC®) to prevent surgical site infection, in patients undergoing internal osteosynthesis for closed fractures.

Materials and methods

In this multicenter randomized controlled prospective study, a total of 256 patients in five European orthopedic centers who were scheduled to receive osteosynthesis for a closed fracture, were randomly assigned to receive antibiotic-loaded DAC or to a control group (without coating). Pre- and postoperative assessment of laboratory tests, wound healing, clinical scores and X-rays were performed at fixed time intervals.

Results

Overall, 253 patients were available with a mean follow-up of 18.1 ± 4.5 months (range 12–30). On average, wound healing, clinical scores, laboratory tests and radiographic findings did not show any significant difference between the two groups. Six surgical site infections (4.6%) were observed in the control group compared to none in the treated group (P < 0.03). No local or systemic side-effects related to the DAC hydrogel product were observed and no detectable interference with bone healing was noted.

Conclusions

The use of a fast-resorbable antibiotic-loaded hydrogel implant coating provides a reduced rate of post-surgical site infections after internal osteosynthesis for closed fractures, without any detectable adverse event or side-effects.

Level of evidence

2.
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Metadata
Title
Fast-resorbable antibiotic-loaded hydrogel coating to reduce post-surgical infection after internal osteosynthesis: a multicenter randomized controlled trial
Authors
Kostantinos Malizos
Michael Blauth
Adrian Danita
Nicola Capuano
Riccardo Mezzoprete
Nicola Logoluso
Lorenzo Drago
Carlo Luca Romanò
Publication date
01-06-2017
Publisher
Springer International Publishing
Published in
Journal of Orthopaedics and Traumatology / Issue 2/2017
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI
https://doi.org/10.1007/s10195-017-0442-2

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