Efficacy of antibacterial-loaded coating in an in vivo model of acutely highly contaminated implant

The purpose of this study was to test the ability of DACA (R), a fast resorbable, antibacterial-loaded hydrogel coating, to prevent acute bacterial colonization in an in vivo model of an intra-operatively highly contaminated implant. A histocompatibility study was performed in 10 adult New Zealand rabbits. Then, methicillin-resistant Staph. aureus were inoculated in the femur of 30 adult New Zealand rabbits at the time of intra-medullary nailing; vancomycin-loaded DACA (R) coated nails were compared to controls regarding local and systemic infection development. Histocompatibility study showed no detrimental effect of DACA (R) hydrogel on bone tissue after 12 weeks from implant. After seven days from implant, none of the rabbits receiving vancomycin-loaded DACA (R) nail showed positive blood cultures, compared to all the controls; vancomycin-loaded DACA (R) coating was associated with local bacterial load reduction ranging from 72 to 99 %, compared to controls. Vancomycin-loaded DACA (R) coating is able to significantly reduce bacterial colonization in an animal model of an intra-operatively highly contaminated implant, without local or general side effect.