Kristo Nuutila1, Josh Grolman2,3, Lu Yang1, Michael Broomhead1, Stuart Lipsitz4, Andrew Onderdonk5, David Mooney2,3, Elof Eriksson1. 1. Applied Tissue Technologies LLC, Hingham, Massachusetts. 2. Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, Massachusetts. 3. John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts. 4. Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 5. Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Abstract
Objective: There is an unmet need to improve immediate burn care, particularly when definitive treatment is delayed. Therefore, the purpose of this project was to formulate a hydrogel that contains very high concentrations of antibiotics and validate its use together with a platform wound device (PWD) for the immediate care of burns. Approach: The hydrogel properties were optimized by using a rheometer, differential scanning calorimetry, and liquid chromatography-mass spectrometry and were tested in an infected porcine burn model. Immediately, after burn creation, the burns were infected with different bacteria. Subsequently, the burns infected with Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii were covered with the PWD and treated with a single dose of hydrogel containing 1000 × minimum inhibitory concentration of vancomycin, gentamicin, and minocycline, respectively. On day 7 or 45, the animals were euthanized, and the burns were harvested for histology and quantitative bacteriology. Results: 0.625% was the best alginate concentration for the hydrogel in terms of viscosity, stability, and drug release. The porcine studies demonstrated that vancomycin-, gentamicin-, and minocycline-treated tissues contained significantly less bacteria and reduced depth of tissue necrosis in comparison to controls. Innovation: The PWD represents a platform technology that begins at the point of the first treatment by protecting the wound and allowing administration of topical therapeutics. The device can be adapted to enclose any size burn over any contour of the body. Conclusion: Antibiotics can be delivered safely in very high concentrations in a hydrogel using the PWD, and burn infections can be treated successfully with this method. Copyright 2020, Mary Ann Liebert, Inc., publishers.
Objective: There is an unmet need to improve immediate burn care, particularly when definitive treatment is delayed. Therefore, the purpose of this project was to formulate a hydrogel that contains very high concentrations of antibiotics and validate its use together with a platform wound device (PWD) for the immediate care of burns. Approach: The hydrogel properties were optimized by using a rheometer, differential scanning calorimetry, and liquid chromatography-mass spectrometry and were tested in an infected porcine burn model. Immediately, after burn creation, the burns were infected with different bacteria. Subsequently, the burns infected with Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii were covered with the PWD and treated with a single dose of hydrogel containing 1000 × minimum inhibitory concentration of vancomycin, gentamicin, and minocycline, respectively. On day 7 or 45, the animals were euthanized, and the burns were harvested for histology and quantitative bacteriology. Results: 0.625% was the best alginate concentration for the hydrogel in terms of viscosity, stability, and drug release. The porcine studies demonstrated that vancomycin-, gentamicin-, and minocycline-treated tissues contained significantly less bacteria and reduced depth of tissue necrosis in comparison to controls. Innovation: The PWD represents a platform technology that begins at the point of the first treatment by protecting the wound and allowing administration of topical therapeutics. The device can be adapted to enclose any size burn over any contour of the body. Conclusion: Antibiotics can be delivered safely in very high concentrations in a hydrogel using the PWD, and burn infections can be treated successfully with this method. Copyright 2020, Mary Ann Liebert, Inc., publishers.
Authors: Lauren Tracy Daly; David M Tsai; Mansher Singh; Kristo Nuutila; Raquel A Minasian; Cameron C Y Lee; Elizabeth Kiwanuka; Florian Hackl; Andrew B Onderdonk; Johan P E Junker; Elof Eriksson; Edward J Caterson Journal: Plast Reconstr Surg Date: 2016-11 Impact factor: 4.730
Authors: Matthew P Rowan; Leopoldo C Cancio; Eric A Elster; David M Burmeister; Lloyd F Rose; Shanmugasundaram Natesan; Rodney K Chan; Robert J Christy; Kevin K Chung Journal: Crit Care Date: 2015-06-12 Impact factor: 9.097
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