Protecting the skin‐implant interface with transcutaneous silver‐coated skin‐and‐bone‐integrated pylon in pig and rabbit dorsum models

Abstract

Implant‐associated soft tissue infections at the skin‐implant interface represent the most frequent complications in reconstructive surgery and lead to implant failures and revisions. Titanium implants with deep porosity, called skin‐and‐bone‐integrated‐pylons (SBIP), allow for skin ingrowth in the morphologically natural direction, thus restoring a reliable dermal barrier and reducing the risk of infection. Silver coating of the SBIP implant surface using physical vapor deposition technique offers the possibility of preventing biofilm formation and exerting a direct antimicrobial effect during the wound healing phase. In vivo studies employing pig and rabbit dorsum models for assessment of skin ingrowth into the pores of the pylon demonstrated the safety of transcutaneous implantation of the SBIP system. No postoperative complications were reported at the end of the follow‐up period of 6 months. Histological analysis proved skin ingrowth in the minipig model without signs of silver toxicity. Analysis of silver release (using energy dispersive X‐ray spectroscopy) in the model of intramedullary‐inserted silver‐coated SBIP in New Zealand rabbits demonstrated trace amounts of silver after 3 months of in‐bone implantation. In conclusion, selected temporary silver coating of the SBIP implant surface is powerful at preventing the periprosthetic infections without imparing skin ingrowth and can be considered for clinical application.

Silver‐Containing Biomaterials for Biomedical Hard Tissue Implants

“…Reproduced with permission. [ 213 ] Copyright 2020, John Wiley and Sons. J) A comparison was made between a silver‐coated proximal femur prosthesis explanted 27 months after surgery and a new silver‐coated prosthesis.…”

Osseointegration for Lower-Extremity Amputees

“…Another method that is being studied through in vivo models is the skin and bone integrated pylon (SBIP) system, an implant with deep pores to promote tissue ingrowth. Preliminary animal studies in both porcine and rabbit models demonstrated tissue ingrowth and the formation of a natural barrier 40 . As a general guiding principle, it is imperative to be judicious when deciding whether to graft bone to the implant interface given the expected donor site morbidity, prolonged surgical time, and the potential infection risk associated with graft harvest and placement 41 .…”

Template Electrochemical Synthesis of Hydroxyapatite on a Titania–Silver Composite Surface for Potential Use in Implantology

“…Metals and their alloys are considered to be the most suitable for replacing damaged supporting bones as compared to polymers and ceramics. Nowadays, Ti and its alloys are especially promising as biocompatible materials due to their strength and physico-chemical resistance, in combination with a relatively low price and density [6]. However, the slow osseointegration of Ti implants still remains a significant problem.…”