Vancomycin–impregnated electrospun polycaprolactone (PCL) membrane for the treatment of infected bone defects: An animal study

There is no consensus for the management of critical infected bone defects. The purpose of this study was to produce a vancomycin–impregnated electrospun polycaprolactone (PCL) membrane for the treatment of infected critical bone defects, and test it in a rabbit model. Electrospinning produced a resorbable PCL fiber membrane containing vancomycin approximately 1 mm in thickness, with a pore diameter of <10 μm. Femur defects were made in the limbs of 18 rabbits and infected with Staphylococcus aureus. The rabbits were divided into three groups according to treatment: (1) Experimental group: rabbit freeze-dried allogeneic bone graft and the vancomycin–PCL membrane. (2) Control group 1: bone graft. (3) Control group 2: vancomycin–PCL membrane only. Culture showed no difference in osteoclast activity between the three groups. Transwell testing showed that almost no fibroblasts passed through the membrane during the first 24 h, but some fibroblasts were able to pass it after 72 h. At 12 weeks after surgery, there was significantly less inflammatory cell infiltration in the experimental compared to the control groups. New bone formation and fracture bone callus were greater in the experimental group than control groups. We thus conclude the resorbable electrospun vancomycin–impregnated PCL membrane was effective at controlling bone infection, and in the regeneration of bone in a critical bone defect animal model.

[1]  Yizhou Zhu,et al.  Construction of poly (vinyl alcohol)/poly (lactide-glycolide acid)/vancomycin nanoparticles on titanium for enhancing the surface self-antibacterial activity and cytocompatibility. , 2017, Colloids and surfaces. B, Biointerfaces.

[2]  Aleksandra M Urbanska,et al.  A bird's eye view on the use of electrospun nanofibrous scaffolds for bone tissue engineering: Current state-of-the-art, emerging directions and future trends. , 2016, Nanomedicine : nanotechnology, biology, and medicine.

[3]  A. C. Jayasuriya,et al.  The use of nanomaterials to treat bone infections. , 2016, Materials science & engineering. C, Materials for biological applications.

[4]  Evan K Wujcik,et al.  Coaxial electrospun fibers: applications in drug delivery and tissue engineering. , 2016, Wiley interdisciplinary reviews. Nanomedicine and nanobiotechnology.

[5]  Xianqun Fan,et al.  Electrospun silk fibroin/poly(lactide-co-ε-caprolactone) nanofibrous scaffolds for bone regeneration , 2016, International journal of nanomedicine.

[6]  C. Jang,et al.  Antibacterial effect of electrospun polycaprolactone/polyethylene oxide/vancomycin nanofiber mat for prevention of periprosthetic infection and biofilm formation. , 2015, International journal of pediatric otorhinolaryngology.

[7]  H. Yoo,et al.  Therapeutic application of electrospun nanofibrous meshes. , 2014, Nanomedicine.

[8]  A. Blevins,et al.  Effectiveness of local vancomycin powder to decrease surgical site infections: a meta-analysis. , 2014, The spine journal : official journal of the North American Spine Society.

[9]  Michał Moritz,et al.  The newest achievements in synthesis, immobilization and practical applications of antibacterial nanoparticles , 2013 .

[10]  S. Giannitelli,et al.  Electrospinning of PCL/PVP blends for tissue engineering scaffolds , 2013, Journal of Materials Science: Materials in Medicine.

[11]  L. Qin,et al.  Amphiregulin-EGFR Signaling Mediates the Migration of Bone Marrow Mesenchymal Progenitors toward PTH-Stimulated Osteoblasts and Osteocytes , 2012, PloS one.

[12]  P. Giannoudis,et al.  The role of barrier membranes for guided bone regeneration and restoration of large bone defects: current experimental and clinical evidence , 2012, BMC Medicine.

[13]  B. Matthews,et al.  Development of novel electrospun absorbable polycaprolactone (PCL) scaffolds for hernia repair applications , 2012, Surgical Endoscopy.

[14]  P. Merloz,et al.  Bone transport techniques in posttraumatic bone defects. , 2012, Orthopaedics & traumatology, surgery & research : OTSR.

[15]  Alessandro Bistolfi,et al.  Antibiotic-Loaded Cement in Orthopedic Surgery: A Review , 2011, ISRN orthopedics.

[16]  J. Parvizi,et al.  Antibacterial activity of bone allografts: comparison of a new vancomycin-tethered allograft with allograft loaded with adsorbed vancomycin. , 2011, Bone.

[17]  S. Guelcher,et al.  Sustained release of vancomycin from polyurethane scaffolds inhibits infection of bone wounds in a rat femoral segmental defect model. , 2010, Journal of controlled release : official journal of the Controlled Release Society.

[18]  P. Giannoudis,et al.  Current management of long bone large segmental defects , 2010 .

[19]  Byong-Taek Lee,et al.  Electro-spinning of PLGA/PCL blends for tissue engineering and their biocompatibility , 2010, Journal of materials science. Materials in medicine.

[20]  Tom Coenye,et al.  Polypropylene grafted with smart polymers (PNIPAAm/PAAc) for loading and controlled release of vancomycin. , 2008, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[21]  G. Gosheger,et al.  Effectiveness of hydroxyapatite-vancomycin bone cement in the treatment of Staphylococcus aureus induced chronic osteomyelitis. , 2005, Biomaterials.

[22]  Colleen L Flanagan,et al.  Bone tissue engineering using polycaprolactone scaffolds fabricated via selective laser sintering. , 2005, Biomaterials.

[23]  L. Dahners,et al.  Effect of Cefazolin and Vancomycin on Osteoblasts In Vitro , 1996, Clinical orthopaedics and related research.

[24]  S. Gogolewski,et al.  Biodegradable guide for bone regeneration. Polyurethane membranes tested in rabbit radius defects. , 1992, Acta orthopaedica Scandinavica.

[25]  A. Ham,et al.  Ham's histology , 1987 .

[26]  J O Hollinger,et al.  The critical size defect as an experimental model for craniomandibulofacial nonunions. , 1986, Clinical orthopaedics and related research.

[27]  C. Levene Histology—a Text and Atlas , 1976 .

[28]  V. Uskoković Nanostructured platforms for the sustained and local delivery of antibiotics in the treatment of osteomyelitis. , 2015, Critical reviews in therapeutic drug carrier systems.

[29]  M. Lis,et al.  Drug release system of ibuprofen in PCL-microspheres , 2012, Colloid and Polymer Science.

[30]  R. Tiwari,et al.  Drug delivery systems: An updated review , 2012, International journal of pharmaceutical investigation.

[31]  R. Meinig Clinical use of resorbable polymeric membranes in the treatment of bone defects. , 2010, The Orthopedic clinics of North America.

[32]  K. Chong,et al.  Induced membranes--a staged technique of bone-grafting for segmental bone loss: a report of two cases and a literature review. , 2010, The Journal of bone and joint surgery. American volume.

[33]  Hershel Raff,et al.  Human Physiology: The Mechanisms of Body Function , 2006 .

[34]  S. Nyman,et al.  Membrane-guided bone regeneration. Segmental radius defects studied in the rabbit. , 1995, Acta orthopaedica Scandinavica.