Endoprosthetics of joints is referred to as progressive and constantly developing methods of surgical treatment of patients with lesions of the musculoskeletal system of any genesis. However, the trend towards to increase of the number of endoprosthetics is inevitably accompanied by increasing in the number of patients with periprosthetic infection.
Prevention of periprosthetic infection consists not only in observing the rules of asepsis and antiseptics during the operation, but also in the selection of rational antibiotic therapy, which will ensure complete eradication of pathogenic bacteria and prevent the formation of biofilm on the surface of endoprosthesis, thereby preventing an acute postoperative periprosthetic inflammatory process that occurs for the first 3 months after surgery. The solution to the problem, from our point of view, can be achieved via using of polymer antimicrobial gels that provide a prolonged release of antimicrobial drugs in the area of periprosthetic inflammation.
To develop this kind of medical devices, a number of studies are required, including studies of local tissue reactions at the cellular level, studies of parenchymal organs and blood tests in order to determine the response of surrounding tissues to implantation and study of general toxic effects. We studied gels based on polyvinylpyrrolidone (PVP) with different viscosities and with addition of antibiotics. The test samples were implanted into the femoral muscle group of experimental animals.
In all studied tissue samples, after the use of different types of gels, differing in viscosity, the presence of bacterial microflora was not detected.
The inflammatory reaction in the form of infiltration by lymphoid cells was noticed only near the injected gels and did not spread into deeper layers of tissues.
The manifested tissue reaction is associated with mechanical stress, depending on the size and viscosity of the samples.
The detected diffusion of PVP-based gels into adjacent tissues and the formation of capsules from connective tissue is associated with the onset of its biodegradation.
The developed gels based on PVP, regardless of the manufacturing method, are inert in relation to the surrounding tissues, do not have a toxic effect on soft tissues and the body as a whole. The revealed insignificant inflammatory reaction in the surrounding tissues indicates an adequate local tissue reaction to the injection of foreign substance and the corresponding mechanical action during the period of exposure of the gels at the injection site.
Despite the different physicochemical properties of the gels, no critical local and general pathologies were identified, which suggests gels inertness in relation to the surrounding tissues and the absence of toxicity.