Carboxymethyl chitosan-zinc coating for prevention of pin tract infection: An animal model

J Orthop Surg (Hong Kong). 2018 Jan-Apr;26(1):2309499017749981. doi: 10.1177/2309499017749981.

Abstract

Background: Pin tract infection is a common problem in orthopedic and traumatology surgery. The aim of this study was to investigate the efficacy of an implant coated with carboxymethyl chitosan-zinc (CMC-Zn2+) in prevention of pin tract infection.

Materials and methods: Twenty-four male New Zealand White rabbits were randomized into two equal groups ( n = 12, uncoated and CMC-Zn2+). The implants were colonized with 1 × 106 colony forming units of Staphylococcus aureus and inserted into the lateral right proximal tibia in each rabbit. In each group, at 2 and 4 weeks post-surgery, five and seven rabbits were killed, respectively, to harvest the soft tissues around the implant as well as the hard tissue for histological analysis. The bone cross-sectional view, X-ray, and micro-computed tomography (μCT) were performed.

Results: The surgical sites in each animal were evaluated individually at both time points. No evident signs of infections were found in the CMC-Zn2+ group, while a high rate of infection was observed in the uncoated group where minor infections were 85.71% ( n = 12) and major infections 14.29% ( n = 12). The radiography, μCT, and histological analysis showed no evident signs of infection in both groups at 2 weeks post-surgery. However, at 4 weeks, signs of infection were found in all the animals in the uncoated group, whereas in the CMC-Zn2+ group, no infections were observed. The difference between the two groups was highly significant ( p = 0.00).

Conclusions: Our study showed that CMC-Zn2+-coated implants were effective in preventing pin tract infection.

Keywords: Staphylococcus aureus; animal models; antibacterial agent; carboxymethyl chitosan-zinc; coating implant; pin tract infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bone Nails / adverse effects*
  • Chitosan / analogs & derivatives*
  • Coated Materials, Biocompatible*
  • Cross-Sectional Studies
  • Disease Models, Animal
  • Fracture Fixation, Internal / adverse effects
  • Male
  • Prostheses and Implants / adverse effects*
  • Prosthesis-Related Infections / prevention & control*
  • Rabbits
  • Staphylococcal Infections / prevention & control*
  • Staphylococcus aureus / isolation & purification
  • Tibia / pathology
  • Tibial Fractures / surgery
  • X-Ray Microtomography
  • Zinc*

Substances

  • Coated Materials, Biocompatible
  • carboxymethyl-chitosan
  • Chitosan
  • Zinc