Abstract Details

Presented By: Isackson, Dorthyann
Affiliated with: University of Utah, Department of Biomedical Engineering
Authors: Dorthyann Isackson, Beau Bailey, Nicholas A. Brown Ph.D., Cathy Petti M.D., Kent N. Bachus Ph.D.
From: University of Utah
Title
Utilizing Porous Metal Dermal Barriers to Prevent Infection of Percutaneous Implants
Abstract

Percutaneous implants (i.e. catheters osseointegrated prostheses) are prone to infection at the skin/implant interface. Implant success relies upon a strong, firm attachment of the skin and soft tissue to the implant. The goal of this research is to inhibit infection of percutaneous implants with the use of a porous metal dermal barrier when compared to a smooth metal dermal barrier. Medical grade titanium implants consisted of two elements: a subcutaneous flange and a percutaneous post. Four implant surface combinations were investigated: (1) smooth flange with a smooth post, (2) smooth flange with a porous post, (3) porous flange with a smooth post, and (4) porous flange with a porous post. Ten New Zealand White rabbits each received on the dorsum four implants, one of each surface combination. Ten weeks post-implantation, animals were challenged weekly with a 10^8 concentration of Staphylococcus aureus solution. At sign of chronic inflammation, bacterial cultures and biopsies were taken at the tissue/implant interface, the animal was then euthanized. The implants with soft tissue were fixed in formalin, embedded in methyl methacrylate, stained with Giemsa, and analyzed with light microscopy. To date, we report on five of ten animals. Smooth implants had visible signs of infection after 5 weekly treatments of bacterial solution, while the porous implants had visible signs of infection after 9 weekly treatments. The porous posts did not have visible epidermal downgrowth, but had an intimate contact with the skin. In contrast, the smooth posts had a gap at the skin/implant interface, and moved very easily upon rotation. Collagen fibers were aligned perpendicularly to the porous implants, but were aligned parallel to the smooth implants. Fibroblasts were seen infiltrating the pores of the porous implants. An influx of inflammatory cells were seen around the smooth surfaces. The results demonstrate that porous percutaneous implants have a reduced rate of infection seen at the tissue/implant interface when compared to smooth percutaneous implants. However, this implant treatment did not completely inhibit infection; continued efforts toward this goal are planned.