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Shocking: Elimination of S. Aureus Biofilm from Stainless Steel by Electrolysis Matthew J. Dietz, MD; Jacob Conjeski MD; Vincent L. Kish AS; Brian R. Hamlin, MD West Virginia University Department of Orthopaedics
Orthopaedic Biofilm Orthopaedic Biofilm Adherent Bacteria Adherent Bacteria EPS (extra-cellular polysaccharide) EPS (extra-cellular polysaccharide) Polymicrobial Polymicrobial
S. Aureus S. Epi EPS Implant Spork
“race for the surface” -- Gristina, A. “Biomaterial-Centered Infection: Microbial Adhesion Versus Tissue Integration. Science. Vol. 237, No. 4822. (Sep. 25, 1987), pp. 1588-1595 Bacterial Colonization vs. Tissue Integration Bacterial Colonization vs. Tissue Integration 100 - 1000x Antibioticsto Eliminate Biofilm
Debridement with Retention Staged Explant/Exchange Resection Arthroplasty ArthrodesisAmputation
S. aureus S. aureusBIOFILM
Biofilm and WVU Orthopaedics Create Biofilm --Goeres et. al. “Statistical assessment of a laboratory method for growing biofilms.” Microbiology. 2005; 151: 757-762.
Where’s the Biofilm?
-- Rabinovitch, C et al. “Removal and Inactivation of Staphylococcus epidermidis Biofilms by Electrolysis.” App and Enviromental Microbiology. Sept 2006: 6364-66.
Control1 Volts Avg. 52.65% reduction in CFU’s/cm2 Anode (n=5) (n=5) Cathode Avg. 92.59% reduction in CFU’s/cm2
Biofilm and WVU Orthopaedics
Control 4 V 2 V 1 V 0.5 V
Conclusions Need for adjuntive measures Connection to Cathode for S. aureus CFU reduction independent of voltage 98% of CFU’s via electrolysis 98% of CFU’s via electrolysis
To Do List… Biofilm Models Detection of Biofilm Electrolysis Various Metals In-vivo Vary biofilm makeup Means of Removal
The War Continues… Thank You
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