Cytotoxicity of a new antimicrobial coating for surgical screws: an in vivo study
Abstract
he risk of surgery-related infection is a persistent problem in orthopaedics and infections involving
implants are particularly difficult to treat. This study explored the responses of bone and soft tissue to antimicrobialcoated screws. We investigated whether such screws, which have never been used to fix bony tissues, would result in
a cytotoxic effect. We hypothesised that the coated screws would not be toxic to the bone and that the likelihood of
infection would be reduced since bacteria are not able to grow on these screws.
METHODS Titanium screws were inserted into the left supracondylar femoral regions of 16 rabbits. The screws
were either uncoated (control group, n = 8) or coated with a polyvinylpyrrolidone-polyurethane interpolymer with
tertiary amine functional groups (experimental group, n = 8). At Week 6, histological samples were obtained and
examined. The presence of necrosis, fibrosis and inflammation in the bony tissue and the tissue surrounding the
screws was recorded.
RESULTS Live, cellular bone marrow was present in all the rabbits from the experimental group, but was replaced with
connective tissue in four rabbits from the control group. Eight rabbits from the control group and two rabbits from the
experimental group had necrosis in fatty bone marrow. Inflammation was observed in one rabbit from the experimental
group and five rabbits from the control group.
CONCLUSION Titanium surgical screws coated with polyvinylpyrrolidone-polyurethane interpolymer were associated with
less necrosis than standard uncoated screws. The coated screws were also not associated with any cytotoxic side effect. Background: Heterozygous beta thalassemia (HBT) has been proposed to increase the risk of developing autoimmune disease. Our aim in this study was to examine the prevalence of HBT among multiple sclerosis (MS) patients.
Material/Methods: HBT frequency was investigated in our MS group (243 patients with MS). Hemoglobin electrophoresis (HE) was
carried out if MS patients had a mean corpuscular volume of (MCV) <80 fL and a mean corpuscular hemoglobin level of (MCH) <27 pg/L according to a complete blood count (CBC). If MCV was lower than 80 fL, MCH was
lower than 27 pg/L, and Hemoglobin A2 equal to or higher than 3.5%, a diagnosis of HBT was established. The
frequency of patients with HBT in our MS patient group was statistically compared with the prevalence of HBT
in the city of Istanbul, where our MS patients lived.
Results: The HBT prevalence was 0.823% (2 patients) in the MS patient group. The prevalence of HBT in Istanbul has
been reported to be 4.5%. According to the z-test, the HBT prevalence in our MS patient group was significantly lower than that in Istanbul (Z=6.3611, two-sided p value <0.0001, 95% confidence interval of prevalence of
HBT in our MS patient group: 0.000998–0.029413).
Conclusions: Contrary to our hypothesis at the outset of study, the reduced HBT prevalence in the MS group compared to
HBT frequency in the city of Istanbul might indicate that HBT is protective against MS.