Background: Cochlear implant (CI)-related wound infections are known to happen even years after the implant procedure and present a challenging clinical situation. Due to the formation of biofilm on the implant surface such infections are difficult to eradicate. Invariably explantation of the device is required for wound healing.
Method: A 10-year-old patient presented with recurrent CI-related wound infection 8 years after implantation. The implant was salvaged with wound debridement and treating it with tea tree oil which is known for its biofilm eradicating properties. It was then covered with double layer of vascularised soft tissue. Combination of intravenous vancomycin and oral rifampicin known for their efficacy in biofilm-related infection was also used.
Results: The implant could be salvaged using this novel technique of treating the implant with a biofilm eradicating agent, wound debridement, double layer vascularised soft tissue cover, and long-term antibiotics.
Conclusion: Agents having anti-biofilm activity when used in conjunction with surgical debridement and judicious antimicrobial therapy can be used for salvaging the implant and limiting the morbidity associated with these infections. 相似文献
BACKGROUND: Polylactic acid-glycolic acid polymer is a sustained-release material with relatively large drug loading and long-term release abilities that can degrade with cell growth in the body. However, its poor hydrophily easily leads to aseptic inflammation that is detrimental to the body’s recovery.
OBJECTIVE: To study the release and distribution of anti-tuberculosis drug delivery materials locally oriented within the rabbit radius.
METHODS: After modeling, 20 New Zealand white rabbits with distal radius bone defect were randomly divided into a control group and an experimental group, which were respectively given implantation of isoniazid-rifampicin polylactic acid-glycolic acid polymer/β-tricalcium phosphate material and isoniazid-rifampicin polylactic acid-glycolic acid polymer into the defect. Then, X-ray examination of the defect region was conducted at weeks 4, 8, 12 post implantation. Histological observation and detection of peripheral blood or local blood concentration were performed at week 12.
RESULTS AND CONCLUSION: After implantation, Lane-Sandhu X-ray scores were significantly higher in the experimental group than the control group (P < 0.05). The defect in the experimental group was healed completely with less release residual among newborn bone trabeculae and osteocytes were markedly visible on the material surface, while in the control group, new bone tissues were interconnected with the surrounding bone tissues at the defect site, and less release residual was found. Both peripheral blood and local blood concentrations in the experimental group were significantly higher than those in the control group after implantation (P < 0.05). To conclude, the anti-tuberculosis drug delivery material, isoniazid-rifampicin polylactic acid-glycolic acid polymer/β-tricalcium phosphate, has ideal release effect that can stably deliver anti-tuberculosis drugs for a long term at a high bactericidal concentration. 相似文献