Peer-reviewed veterinary case report
How to prevent infection in knee surgery with vancomycin?
By Chao CA et al.·2026·Research Institute, United States·View original on Europe PMC →
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Original publication title: Pretreatment With Vancomycin Prevents Staphylococcal Biofilm Formation on Marlex Mesh.
Plain-English summary
This study looked at whether soaking surgical mesh used in knee surgeries in an antibiotic called vancomycin could stop bacteria from forming a protective layer, known as biofilm, which can lead to infections. The researchers tested different concentrations of vancomycin and found that only the highest concentration, 10 mg/mL, was effective in preventing the growth of a common bacteria called Staphylococcus aureus on the mesh. They confirmed this by using special imaging techniques that showed no biofilm was present on the treated mesh. Overall, the results suggest that using vancomycin to treat surgical mesh can help prevent infections, even after the mesh has been rinsed.
Abstract
<h4>Background</h4>Polypropylene (PPE) mesh is a popular surgical treatment for extensor mechanism disruption in revision knee arthroplasty, but development of infection can be catastrophic. Pretreating orthopedic materials with antibiotics has precedence, but has not yet been described for PPE mesh. The purpose of the current study is to determine if mesh pretreatment with vancomycin could effectively prevent biofilm formation.<h4>Methods</h4>Sterile PPE mesh was cut into 10-mm diameter circles. PPE circles were soaked in saline for 20 minutes with one of the following vancomycin concentrations: 1) 0.625 mg/ml, 2) 1.25 mg/ml, 3) 2.5 mg/ml, 4) 5.0 mg/ml, and 5) 10.0 mg/ml. To simulate surgical irrigation prior to closure, samples were rinsed with saline 0, 1, 2, or 3 times. Each group had 9 samples. Rinsed PPE circles were placed in a 48-well plate, inoculated with 10<sup>6</sup> colony-forming units (CFUs) of methicillin-sensitive <i>Staphylococcus aureus</i>, cultured in tryptic soy broth for 24 hours, rinsed to remove planktonic bacteria, and sonicated in fresh media for 30 minutes. Sonicated fluid was serially diluted and plated for CFUs. Infection prevention was defined as 0 CFUs. PPE circles were imaged with scanning electron microscopy to visualize vancomycin crystals and biofilm.<h4>Results</h4>Pretreatment of PPE mesh with 10 mg/mL of vancomycin was the only condition that prevented <i>S aureus</i> biofilm formation in all conditions. Scanning electron microscopy confirmed that vancomycin pretreatment deposited antibiotic crystals on the mesh surface and that biofilm was not present.<h4>Conclusions</h4>Vancomycin pretreatment of PPE mesh can prevent biofilm formation even after rinsing.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41853806