Abstract

The highly porous Dacron graft fabricated from polyester filaments is generally considered to be one of the most suitable synthetic vascular prostheses in arterial reconstructive surgery. To prevent blood leakage through the pores during an operation, several sealing materials such as albumin (ALB), collagen and gelatin have been employed. As vascular graft infection is a disastrous complication on vascular surgery, great effort must be taken to avoid it. To reduce the systemic effect while maintaining an increase in local resistance to graft infection, it seems reasonable that an antibiotic-loaded graft prolongs the release of antibiotics from the graft at the operated site. Common skin microorganisms, such as Staphylococcus aureus and Staphylococcus epidermidis, have been associated with graft-related infection. Levofloxacin(LVFX) was used as a model drug since it shows a broad protective spectrum against Gram-positive and Gram-negative bacteria, particularly staphylococci. To control the release rate of LVFX, ALB was bonded to the Dacron graft. In vitro and in vivo studies demonstrated that the release rate of LVFX decreased in the presence of ALB. One LVFX-ALB disk (diameter : 1.2 cm) was implanted in the skin pocket made in a rat, and inoculated with Staphylococcus aureus or Staphylococcus epidermidis (0.1 ml of 108 CFU/ml). While all control grafts were infected at the time of removal, all LVFX-ALB Dacron grafts resisted infection, thus demonstrating their effectiveness. These studies suggest that LVFX controlled-releasing Dacron delivery system can decrease graft infection at the operated site.

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