Use of an amikacin‐infused collagen sponge concurrent with implant removal for treatment of tibial plateau leveling osteotomy surgical site infection in 31 cases

Lee, Sylvia J; Frederick, Steven W.; Cross, Alan R.

doi:10.1111/vsu.13249

Cited by 8 publications

(6 citation statements)

References 36 publications

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“…4 The overall complication rate for the TPLO procedure ranges from 9.7% to 34%. [5][6][7] Reported TPLO complications include incision-related and implantrelated complications, delayed union of the osteotomy, 6,7 infection, 8,9 meniscal tear, patellar desmitis, [10][11][12] and fracture of the tibial tuberosity, 13 fibula, 14 and patella. [5][6][7]15,16 Publications regarding the TPLO procedure report a wide range of radiographic follow-up times: 6 weeks, 5,7,11,17,18 8 weeks, 5,[18][19][20][21] and 12 weeks.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the clinical value of routine radiographic examination during convalescence for tibial plateau‐leveling osteotomy

Olivencia-Morell¹,

Frederick²,

Forbes³

et al. 2021

Veterinary Surgery

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Objective: To determine how frequently routine follow-up radiographic findings would result in a change to the postoperative plan following tibial plateau-leveling osteotomy (TPLO) in dogs. Study design: Retrospective study Sample population: Short-term group: 100 cases; intermediate-term group: 50 cases. Methods: Medical records of 100 consecutive cases meeting the inclusion criteria were reviewed (the short-term group). The cases had no owner-perceived issues and underwent routinely prescribed radiographic follow up between 40 and 60 postoperative days after TPLO performed by one experienced surgeon. Complications identified on physical examination (PE) and radiographic examination (RE) were recorded, along with any changes to the postoperative plan. Medical records of 50 consecutive cases that had short-term and intermediate-term (≥180 days) REs and PEs were reviewed similarly (intermediate-term group).Results: Fifty-one cases in the short-term group had no complications on PE or RE. Forty-nine dogs were diagnosed with minor complications (patellar ligament desmitis, patella or fibula fracture, gait abnormalities): 42 on RE only; 6 on PE and RE; 1 on PE only. Exercise restriction was extended for 2 weeks in 2 cases with radiographic patellar ligament desmitis. Two cases in the intermediate-term group had minor complications at intermediate-term RE. No new PE or RE complications developed between short-term and intermediate-term evaluations. Conclusion: At routine rechecks of dogs with no owner-perceived issues after TPLO, 49% had minor complications but only 2% were deemed significant enough to alter patient management. The likelihood of new radiographic complications developing after short-term evaluation is low.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the clinical value of routine radiographic examination during convalescence for tibial plateau‐leveling osteotomy

Olivencia-Morell¹,

Frederick²,

Forbes³

et al. 2021

Veterinary Surgery

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“…The t=0 sample was taken immediately after all specimens were submerged in the same order of assembly and placement. Twenty samples (0.15ml each) were taken over 96 hours with a decrease in frequency (0, 1,2,3,4,5,6,8,10,13,17,22,27,34,42,48,58,66,72, 96 hours) with the sampling order consistent throughout. At 96 hours, an additional sample (by needle aspiration through the tube) of the fluid contained within the dialysis tube was taken.…”

Section: Elutionmentioning

confidence: 99%

“…With the increase in antimicrobial resistance in veterinary medicine [1,2], novel strategies and antimicrobials to combat infections are (re)gaining favor. One strategy might be to deliver a high local dose of antibiotics [3][4][5][6][7]. Another might be to explore the use of non-antibiotic antimicrobials, such as silver (Ag), especially silver nanoparticles (AgNP).…”

Section: Introductionmentioning

confidence: 99%

Silver nanoparticles can be sampled by ultrafiltration probe but elution into & recovery from plasma and DPBS differsin vitro

Risselada,

McCain,

Bates

et al. 2024

Preprint

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We compared 1) the influence of elution fluid on rate, pattern, and completeness of silver nanoparticle (AgNP) elution, and 2) ultrafiltration (UF) probe and direct sampling in vitro. Six specimens (2.5ml of 0.02mg/ml 10nm AgNP and 5.0ml of 30% poloxamer 407) contained in a dialysis tube (12-14kDa pores) were placed in 100ml Dulbecco’s Phosphate Buffered Saline (DPBS) (n=3) or canine plasma (n=3) for 96h on a stirred hot plate (37°C and 600rpm) and sampled 20 times. Six pipette and UF probe samples were taken of a 0.001mg AgNP/ml DPBS or plasma solution. Inductively coupled plasma mass spectrometry was used to analyze Ag. Stock plasma contained Ag. At 96h, 5/6 dialysis tubes had not fully released AgNP. One peak in hourly Ag increase was present in DPBS (10-13h), and two peaks in plasma (6-8h and 10-13h). The hourly Ag increase in plasma decreased earlier than in DPBS. UF probe sampling was possible in both DPBS and plasma and resulted in higher Ag concentrations but with more variation than pipette samples. While in vitro use of DPBS might be more cost effective, plasma should be considered due to difference in elution and recovery.

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“…1 Sustained-release carriers described to deliver antibiotics topically include cements, sponges, antibiotic-impregnated implants, and gels. [4][5][6][7][8][9][10][11] The sustained-release properties of carriers like calcium sulfate hemihydrate (CSH) beads, 12-17 hydrogels, 11,12,17-20 and sponges 12,17 have been demonstrated in in vitro studies and summarized in review papers. 21,22 Hydrogels are biocompatible, biodegradable, and inexpensive.…”

mentioning

confidence: 99%

“…25 Clinical use of topical antibiotic delivery has been described in several veterinary studies, including coated implants, CSH beads, collagen sponges, and polymers. [7][8][9][10][11] The use of antibiotic-impregnated CSH beads has been demonstrated to be largely successful in treating deep SSIs associated with various orthopedic procedures, with no major associated complications. 7,8 Surgical implant removal combined with placement of an amikacin-infused collagen sponge was sufficient for long-term resolution of SSIs associated with tibial plateau leveling osteotomies (TPLOs) in 30 of 31 dogs, including 19 MDR infections.…”

mentioning

confidence: 99%

Amikacin in 30% poloxamer 407 is a versatile local therapy with method of application and outcome documented in 29 dogs

Risselada,

Spies,

Kim

2024

javma

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OBJECTIVE To report the clinical use, adverse events, and outcomes after using amikacin in 30% poloxamer 407 (amikacin-P407) during open wound management or in a closed wound application in dogs. ANIMALS 29 client-owned dogs. METHODS Medical records from January 2017 to August 2023 from a single hospital were reviewed for dogs that received amikacin-P407 in an open or closed wound application. Information reviewed included signalment, nature of wound and/or surgical site infection (SSI), bacterial cultures, amikacin dose, gel volume, route of administration, estimated wound surface area, biochemistry parameters, urine casts, wound progression, and general clinical outcome. RESULTS Amikacin-P407 was applied during open wound care (10 dogs), via injection (5 dogs), and at time of wound closure (13 dogs) and was used both in open and closed wound management (1 dog). Wounds were associated with SSIs in 18 of 30 sites. Multidrug resistance was noted in 21 of 30 preapplication cultures. Median amikacin dose was 14.5 mg/kg (range, 3 to 59.5 mg/kg), median total volume was 5.0 mL (range, 1 to 12 mL), and median tissue surface area was 6.6 cm2 (range, 1.6 to 36 cm2), for a local wound dose of 62.5 mg/cm2 (range, 6.9 to 214.3 mg/cm2). No short-term adverse local or systemic effects were noted in any wounds or dogs. No dehiscence was seen in 17 of 19 closed sites. CLINICAL RELEVANCE The results of this case series suggested that Amikacin-P407 can be applied in a variety of ways with no adverse effects. Amikacin-P407 may be considered in open wound management or in a closed setting for infected wounds and SSIs.

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Use of an amikacin‐infused collagen sponge concurrent with implant removal for treatment of tibial plateau leveling osteotomy surgical site infection in 31 cases

Cited by 8 publications

References 36 publications

Evaluation of the clinical value of routine radiographic examination during convalescence for tibial plateau‐leveling osteotomy

Evaluation of the clinical value of routine radiographic examination during convalescence for tibial plateau‐leveling osteotomy

Silver nanoparticles can be sampled by ultrafiltration probe but elution into & recovery from plasma and DPBS differsin vitro

Amikacin in 30% poloxamer 407 is a versatile local therapy with method of application and outcome documented in 29 dogs

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