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Surgical Site Infections in Veterinary Medicine; A Focus on the Tibial Plateau Levelling Osteotomy and an In Vitro Evaluation of the Elution of Amikacin and Dispersin B From a Local Drug Delivery System

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Title: Surgical Site Infections in Veterinary Medicine; A Focus on the Tibial Plateau Levelling Osteotomy and an In Vitro Evaluation of the Elution of Amikacin and Dispersin B From a Local Drug Delivery System
Author: Hagen, Christopher
Department: Department of Clinical Studies
Program: Veterinary Science
Advisor: Gibson, Tom
Abstract: Surgical site infection (SSI) after tibial plateau leveling osteotomy (TPLO) is a common, frustrating, and expensive complication. The underlying reason for this increased risk of infection is poorly understood but is further complicated by biofilm formation. Emerging resistance, adverse effects of antimicrobials, and altered environments within an infection have revealed a need for local delivery of drugs including antimicrobials and anti-biofilm agents. The objectives of this study were to evaluate potential risk factors associated with SSI after TPLO and determine the in vitro elution profile of amikacin and Dispersin B from a novel polymer hydrogel. Administering pre-operative antibiotics greater than 60 minutes from the first incision and administration of post-operative antibiotics were protective against SSI. Patients younger than 6 and older than 12 years were at higher risk of developing an SSI. Amikacin and Dispersin B both rapidly eluted from the polymer hydrogel in the first 24 hours and there was no clinically significant difference in their total elution over ten days when compounded individually or together. These data suggest further research is required to determine optimal peri-operative antimicrobial regimens including timing and length of administration. Additionally, the combination of amikacin and Dispersin B in a polymer hydrogel had promising results for local treatment of complex infections involving biofilms.
URI: http://hdl.handle.net/10214/17601
Date: 2019
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