Current SSI Stats

In small animal surgery, SSI incidence ranges from 0.8 to 18.1%, and in equine patients, from 5 to 30%.1 As many as 18.2% of dogs experience SSI after orthopedic surgeries, and those with metallic implants are nearly 6 times more likely to develop SSI.3 Even up to 81% of clean orthopedic surgeries with strict adherence to sterile practices have some type of contamination.3

Along with all the factors that affect infection risk, surgeons using implants must also contend with biofilms that form almost immediately.4 Fibroblasts and other host cells adhere to the extracellular matrix that forms on the implant; however, staphylococci can also adhere, spawning a biofilm nearly impenetrable to the host immune system and systemic antibiotics. 4,5 Surgical site infection, especially after implants are placed, prevents healing, hinders implant integration, and may cause premature implant failure.3

Any tool that delivers effective antimicrobial control and doesn’t drive systemic antibiotic resistance or harmful side effects will help prevent and treat SSI.5 That’s a win for pets, their owners, and the veterinary care team.

What’s Been Working
Postoperative systemic antibiotics are a mainstay to prevent and treat SSI. For clean surgeries with implant placement, postoperative antibiotics reduce infections by 84% and are recommended for these procedures and surgeries longer than 2 hours.3 However, they don’t always work and have drawbacks, such as poor penetration/time/concentration at the surgical site, antibiotic resistance, dose-limiting systemic side effects, and owner compliance issues.3,4

What’s New

That’s where local antibiotic delivery options come in. Local antibiotic carriers are getting a lot of buzz lately for the prevention and treatment of SSI.4

They deliver high concentrations of antibiotics exactly where they’re needed—disrupting bacteria, stopping biofilms, and infiltrating necrotic tissue.5, 2 Because these devices are applied locally one time, they avoid most systemic side effects, and owners don’t have to remember every dose. 6,2,4

Smart Infection Control

Clinicians have used cement spacers or beads (which require removal during a subsequent surgery), biodegradable collagen sponges, and biocompatible bone as carriers of locally-eluting antibiotics to prevent and treat local infections.2 They achieve high local antibiotic concentrations, prolong antimicrobial half-life, and demonstrate consistent elution activity.6

Bone cements include polymethylmethacrylate (PMMA), calcium sulfate, and hydroxyapatite.4 PMMA provides physical support and can be mixed with antibiotics before polymerization; however, it is non-biodegradable and requires heat-stable antibiotics.4, 6 It may weaken when combined with certain antibiotics, become a nidus for bacterial colonization, or cause systemic effects.4,6

Calcium sulfate and hydroxyapatite are mixed with water, are biocompatible, and don’t undergo heating or require removal.4,6 Calcium sulfate reliably releases antibiotics and disrupts biofilm in vitro; however, it may cause persistent drainage, ossification, or hypercalcemia.6 Hydroxyapatite’s porous surface promotes healing and bone formation; however, it slowly degrades, limiting consistent antibiotic release and may allow for bacterial colonization.6

Smarter Infection Control

Designed with veterinarians in mind, Osteoallograft^®️ Orthomix^®️ from Movora brand Veterinary Transplant Services (VTS) and CollaVET^™️ Resorbable Wound Healing Implant from Movora brand New Generation Devices (NGD) can be used to deliver antibiotics locally to effectively prevent and treat infection, promote healing, and avoid the drawbacks of systemic antibiotics.

Physical Scaffold

Both provide a physical base for cells to attach and start repairing tissues. Orthomix bone graft uses cancellous bone, while CollaVET resorbable collagen contains purified Type 1 collagen in foam, sponge, and fibrillar matrices.

Local Healing

Each delivers substances to help the body heal faster. The DBM of Orthomix contains bone-derived growth factors, such as bone morphogenetic protein (BMP), and delivers them locally, without the need for allograft bone harvesting. It saves time, money, and morbidity for the patient. CollaVET collagen matrix is designed to be loaded with BMPs, platelet-rich plasma, anti-inflammatories, analgesics, and others, and directly applied to the target site. CollaVET resorbable collagen also helps control bleeding thanks to its collagen fibers' intrinsic hemostatic properties. .

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Smarter Infection Control for Post-Surgical Site Infections