Assessing the effects of topical vancomycin in diabetic fracture healing.
Location
Philadelphia, PA
Start Date
10-5-2021 12:00 AM
End Date
13-5-2021 12:00 AM
Description
Surgical site infections (SSI) impact patients both physically and financially. Concerns of SSIs include prolonged hospitalization, recovery time and increased cost of post-operative care. Prophylactic administration of topical powdered vancomycin at the surgical site has become increasingly common, especially in the setting of diabetes. This study aims to identify the effects of locally administered vancomycin powder on fracture healing in BB Wistar rats with Type 1 Diabetes Mellitus (T1DM) and its dose-response in vitro. We hypothesize that local vancomycin at high doses has the potential to inhibit bone formation.
T1DM BB Wistar rats, aged 80-141 days were utilized to assess the following in vivo parameters: Radiographic Scoring (n=17), Mechanical Testing (n=17), Histomorphometry (n=52), and μ-CT (n=14). Following a femur fracture model, a longitudinal incision was made, exposing the fracture. Powdered vancomycin (25 mg/kg) was placed at the fracture site for the treatment group. Cell culture experiments were performed, with bone marrow harvested from male non-diabetic BB Wistar rats to determine the dose-response of vancomycin on osteoblast mineralization in vitro.
In cell culture, alkaline phosphatase staining found that the area of the untreated cells at 14 days after treatment was 37.0% higher than the 50 μg/mL dose and 56.6% higher than 500 μg/mL dose (not statistically significant). Alizarin red-s staining showed similar results. We found no difference in 7 days staining. In vivo studies in DM rats showed no difference in testing parameters.This preliminary study indicates no effect from local Vancomycin at the analyzed dosage upon fracture healing after 6 weeks. In vitro studies suggest that prolonged administration of vancomycin at high doses can impair the osteogenic capacity of bone marrow derived precursor cells. However, topical vancomycin’s capacity to reduce infection risk still supports its use in the surgical setting.
Embargo Period
6-3-2021
Assessing the effects of topical vancomycin in diabetic fracture healing.
Philadelphia, PA
Surgical site infections (SSI) impact patients both physically and financially. Concerns of SSIs include prolonged hospitalization, recovery time and increased cost of post-operative care. Prophylactic administration of topical powdered vancomycin at the surgical site has become increasingly common, especially in the setting of diabetes. This study aims to identify the effects of locally administered vancomycin powder on fracture healing in BB Wistar rats with Type 1 Diabetes Mellitus (T1DM) and its dose-response in vitro. We hypothesize that local vancomycin at high doses has the potential to inhibit bone formation.
T1DM BB Wistar rats, aged 80-141 days were utilized to assess the following in vivo parameters: Radiographic Scoring (n=17), Mechanical Testing (n=17), Histomorphometry (n=52), and μ-CT (n=14). Following a femur fracture model, a longitudinal incision was made, exposing the fracture. Powdered vancomycin (25 mg/kg) was placed at the fracture site for the treatment group. Cell culture experiments were performed, with bone marrow harvested from male non-diabetic BB Wistar rats to determine the dose-response of vancomycin on osteoblast mineralization in vitro.
In cell culture, alkaline phosphatase staining found that the area of the untreated cells at 14 days after treatment was 37.0% higher than the 50 μg/mL dose and 56.6% higher than 500 μg/mL dose (not statistically significant). Alizarin red-s staining showed similar results. We found no difference in 7 days staining. In vivo studies in DM rats showed no difference in testing parameters.This preliminary study indicates no effect from local Vancomycin at the analyzed dosage upon fracture healing after 6 weeks. In vitro studies suggest that prolonged administration of vancomycin at high doses can impair the osteogenic capacity of bone marrow derived precursor cells. However, topical vancomycin’s capacity to reduce infection risk still supports its use in the surgical setting.