Abstract：
:Mandibular reconstruction requires functional and aesthetic repair and is further complicated by contamination from oral and skin flora. Antibiotic-releasing porous space maintainers have been developed for the local release of vancomycin and to promote soft tissue attachment. In this study, mandibular defects in six sheep were inoculated with 106 colony forming units of Staphylococcus aureus; three sheep were implanted with unloaded porous space maintainers and three sheep were implanted with vancomycin-loaded space maintainers within the defect site. During the same surgery, 3D-printed in vivo bioreactors containing autograft or xenograft were implanted adjacent to rib periosteum. After 9 weeks, animals were euthanized, and tissues were analyzed. Antibiotic-loaded space maintainers were able to prevent dehiscence of soft tissue overlying the space maintainer, reduce local inflammatory cells, eliminate the persistence of pathogens, and prevent the increase in mandibular size compared to unloaded space maintainers in this sheep model. Animals with an untreated mandibular infection formed bony tissues with greater density and maturity within the distal bioreactors. Additionally, tissues grown in autograft-filled bioreactors had higher compressive moduli and higher maximum screw pull-out forces than xenograft-filled bioreactors. In summary, we demonstrated that antibiotic-releasing space maintainers are an innovative approach to preserve a robust soft tissue pocket while clearing infection, and that local infections can increase local and remote bone growth.
journal_name
Biomaterialsjournal_title
Biomaterialsauthors
Watson E,Smith BT,Smoak MM,Tatara AM,Shah SR,Pearce HA,Hogan KJ,Shum J,Melville JC,Hanna IA,Demian N,Wenke JC,Bennett GN,van den Beucken JJJP,Jansen JA,Wong ME,Mikos AGdoi
10.1016/j.biomaterials.2020.120185subject
Has Abstractpub_date
2020-10-01 00:00:00pages
120185eissn
0142-9612issn
1878-5905pii
S0142-9612(20)30431-2journal_volume
256pub_type
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