In vivo comparative study of tissue reaction to bare and antimicrobial polymer coated transcutaneous implants.

We coated transcutaneous implants made of titanium alloy Ti6Al4V with copolymer dimethyl (2-methacryloyloxy-ethyl) phosphonate and 4-vinylpyridine and investigated the tissue reaction with respect to its biocompatible and antimicrobial properties in vivo. We distinguished between clinically observable superficial inflammations and histologically detectable deep infections. The vinylpyridine moieties were transferred into cationic pyridinium groups by reaction with hexyl bromide. Thus polymers with both antimicrobial capacity and good biocompatibility were obtained. In a short-term study, we implanted specially designed bare or coated implants in hairless but immunocompetent mice and analyzed the tissue reaction histologically. No difference was found between bare and coated implants in the initial healing phase of up to 14 days; however, after 21 days the scar tissue formation was higher in the bare implant group. The degree of epithelial downgrowth was comparable in both groups at any time point. In a long-term study of up to 168 days, we analyzed resistance to infection. In the bare implant group, 7 of the 12 implantation sites became infected deep whereas in the coated implant group only two deep infections were observed. The other implantation sites showed only superficial signs of inflammation. These results generally accord with previous in-vitro studies.

Antimicrobial surface coatings for a permanent percutaneous passage in the concept of osseointegrated extremity prosthesis.

The clinical implementation of percutaneous implants is still limited owing to infections at the side of the stoma. In our concept, this issue is addressed by designing copolymer surface coatings possessing biocompatibility and antimicrobial activity to improve the maintenance of a physiological skin seal at the skin-implant interface. Different copolymers with surface-active phosphonate and antimicrobial cationic groups were designed. Thus, coated titanium samples were cultured with bacterial strains or fibroblasts, respectively. Antimicrobial impact was evaluated by imaging the reduction of bacterial adherence. Biocompatibility was displayed by fibroblast proliferation and morphology. A variety of copolymers of 4-vinylpyridine with vinylbenzylphosphonate or dimethyl(2-methacryloyloxy-ethyl) phosphonate were prepared by free radical polymerization. The optimized polymer coating (copolymer D) showed a reduction of adherent bacteria up to 95%, with only a slight reduction in the adherence of human fibroblasts compared with blank titanium controls. In this study, we demonstrate in vitro that polymer surface coatings can be simultaneously antimicrobial and biocompatible. We consider this to be a promising technology for the realization of a permanent aseptic percutaneous passage as needed for the advancement of osseointegrated limb prosthesis.