Abstract
Abstract Implant-associated spine infection (IASI) is related to bacteria and the formation of biofilm. Numerous analyses on the formation mechanism of biofilm have been reported based on in vitro studies. However, the available literature is lacking detailed high-resolution characterization of biofilms on surgically removed implants. The present work deals with the development of a simplified fixation protocol applied on ex-situ Ti-6Al-4V implants. High-resolution scanning electron microscopy was applied for detailed characterization of various types of bacteria as well as biofilm structures. Erythrocytes and Staphylococci as well as fibrin networks were observed on implants removed from different patients. Moreover, the application of the new fixation protocol together with high-resolution microscopy revealed fully developed biofilms totally covering the bacteria as well as very fine structures attaching the bacteria to the implant surfaces, corresponding to early stages of biofilm formation.
Published Version
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