Abstract
Introduction: Since 2009, the IlluminOss® System is being used as an intramedullary fracture treatment. The system is characterized by the use of blue light to polymerize liquid monomer after its infusion in a polyethylene terephthalate balloon. Very few infections of the material have been observed, which might be explained by the possible antimicrobial side-effect of the blue light used in this intramedullary fracture stabilization system. This study aimed to assess this antimicrobial (side-)effect on S. aureus.Methods: A suspension of 1.5 x 103 CFU/ml of 8325-4 S. aureus was placed into five, custom made, black delrin cylinders. The implant was placed into the cylinders and the light source was activated for 200, 400, 600, 800, or 1,000 seconds. 100 µL of the light exposed suspension was grafted on blood agar and placed in a 35 degrees Celsius incubator for 24 hours. Colonies on each agar plate were counted and compared to the control plates (no blue light exposure).Results: The control plates showed a mean of 85 ± 15 colonies per plate. A statistically significant decrease was observed after 600 seconds of exposure time; mean colony count of 63 ± 4 (p <0.05). The absolute reduction was 24 ± 14 after 600 seconds exposure time. At 800 and 1,000 seconds, no statistically significant reduction was found compared with the control plates (means 72 ± 10 and 83 ± 14 colonies, respectively).Conclusions: In this study only a temporary reduction of S. aureus was observed.If future research regarding the antimicrobial characteristics of blue light used in the IlluminOss® System is desired, it should focus on the need for oxygen and its availability and the dose and manner of applying the light.
Highlights
Since 2009, the IlluminOss® System is being used as an intramedullary fracture treatment
If future research regarding the antimicrobial characteristics of blue light used in the IlluminOss® System is desired, it should focus on the need for oxygen and its availability and the dose and manner of applying the light
The essence of the system is that a transparent polyethylene terephthalate (PET)-balloon is introduced into the medullary canal of the bone and subsequently inflated by a liquid, transparent monomer
Summary
Since 2009, the IlluminOss® System is being used as an intramedullary fracture treatment. Very few infections of the material have been observed, which might be explained by the possible antimicrobial side-effect of the blue light used in this intramedullary fracture stabilization system. The IlluminOss® System is a surgical treatment modality designed to stabilize low-weight bearing longbone fractures. It is commercially available in many countries since 2009. The essence of the system is that a transparent polyethylene terephthalate (PET)-balloon is introduced into the medullary canal of the bone and subsequently inflated by a liquid, transparent monomer This monomer hardens by exposure to blue light, transmitted to the balloon by a transparent tube [1]. Since there are no prospective randomized trials executed yet, no hard evidence for this theory exists
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