Evaluation of the Antimicrobial Efficacy of a Novel Rifampin/Minocycline-Coated, Noncrosslinked Porcine Acellular Dermal Matrix Compared With Uncoated Scaffolds for Soft Tissue Repair

• Published in: Surgical innovation 2016-10, Vol.23 (5), p.442-455
• Main Authors: Majumder, Arnab, Scott, Jeffrey R., Novitsky, Yuri W.
• Format: Article
• Language: English
• Subjects: Acellular Dermis - drug effects; Animals; Coated Materials, Biocompatible; Drug Therapy, Combination; Graft Survival; Immunohistochemistry; In Vitro Techniques; Microbial Sensitivity Tests; Microscopy, Electron; Minocycline - pharmacology; Models, Animal; Rabbits; Reference Values; Rifampin - pharmacology; Skin Transplantation - methods; Soft Tissue Injuries - surgery; Stem Cells; Swine
• ISSN: 1553-3506; 1553-3514
• DOI: 10.1177/1553350616656280

Background. Despite meticulous aseptic technique and systemic antibiotics, bacterial colonization of mesh remains a critical issue in hernia repair. A novel minocycline/rifampin tyrosine–coated, noncrosslinked porcine acellular dermal matrix (XenMatrix AB) was developed to protect the device from microbial colonization for up to 7 days. The objective of this study was to evaluate the in vitro and in vivo antimicrobial efficacy of this device against clinically isolated methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli. Methods. XenMatrix AB was compared with 5 existing uncoated soft tissue repair devices using in vitro methods of zone of inhibition (ZOI) and scanning electron microscopy (SEM) at 24 hours following inoculation with MRSA or E coli. These devices were also evaluated at 7 days following dorsal implantation and inoculation with MRSA or E coli (60 male New Zealand white rabbits, n = 10 per group) for viable colony-forming units (CFU), abscess formation and histopathologic response, respectively. Results. In vitro studies demonstrated a median ZOI of 36 mm for MRSA and 16 mm for E coli for XenMatrix AB, while all uncoated devices showed no inhibition of bacterial growth (0 mm). SEM also demonstrated no visual evidence of MRSA or E coli colonization on the surface of XenMatrix AB compared with colonization of all other uncoated devices. In vivo XenMatrix AB demonstrated complete inhibition of bacterial colonization, no abscess formation, and a reduced inflammatory response compared with uncoated devices. Conclusion. We demonstrated that XenMatrix AB possesses potent in vitro and in vivo antimicrobial efficacy against clinically isolated MRSA and E coli compared with uncoated devices.