THE EFFECT OF FIBRIN GLUE AS A LOCAL ANTIBIOTIC CARRIER

ABSTRACT

Fibrin glue(FG) has been successfully used in a wide range of surgical fields such as skin graft fixation, nerve repair, cartilage reattachment and microvascular anastomoses. The sustained release of antibiotics from FG for a longer period is desirable to avoid bacterial infection after application. Furthermore, this is indispensible for FG so as to be used as a local antibiotic carrier. Ampicillin sodium(AMP-Na) was selected as a model antibiotic and incorporated into FG. In an attempt to achieve sustained release of it, the incorporation of AMP-Na into FG was tried in two different ways. One was incorporation of AMP-Na in a dispersed state with the modification of the preparation method of FG. The other was incorporation of bovine serum albumin microspheres(BSA-MS) containing AMP-Na. The in vitro release of AMP-Na from various FG was examined. The modifications of FG were found not to be appropriate methods to achieve sustained release of AMP-Na. However, the incorporation of crosslinked BSA-MS containing AMP-Na into FG was found to reduce the initial rapid release of AMP-Na and retared the release of AMP-Na ; t0.9 was 33 hours. The prophylactic efficacy of antibiotic-loaded FG against pathogenic bacteria was evaluated by artificially induced abscess model in the rabbit. The abscess model in the rabbit was induced by inoculation of pathogenic bacteria(synchronized culture of Staphylococcus aureus). Three different experimental group of pathogenic bacteria was injected into oral mucosa of the rabbit and hisopathological assessment was examined to evaluated the prophylatic efficacy of antibiotic-loaded FG. In pathogen only group, large pus pocket was formed after only 24 hours. However, the abscess diameter of the combination group(i.e.,pathogen and AMP-Na loaded FG) showed much smaller than of pathogen only group. Histopathological study also showed that there was the least inflammatory cell in the combination group of pathogen and BSA-MS loaded FG among the three experimental group tested. These results indicate that antibiotic-loaded FG has not only the prophylactic efficacy against post-operative infection, but also has the potential to be employed as a local biodegradable antibiotic carrier.