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Influence of Absorbable Calcium Sulfate-Based Bone Substitute Materials on Human Haemostasis—In Vitro Biological Behavior of Antibiotic Loaded Implants

Calcium sulfate (CS) formulations are frequently implanted as antibiotically impregnated bone substitutes in orthopedic and trauma surgery to prevent or treat bone infections. Calcium ions have been discussed as candidates to accelerate blood coagulation. The goal of this study is to evaluate substa...

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Autores principales: Pförringer, Dominik, Harrasser, Norbert, Beirer, Marc, Crönlein, Moritz, Stemberger, Axel, van Griensven, Martijn, Lucke, Martin, Burgkart, Rainer, Obermeier, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025628/
https://www.ncbi.nlm.nih.gov/pubmed/29865173
http://dx.doi.org/10.3390/ma11060935
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author Pförringer, Dominik
Harrasser, Norbert
Beirer, Marc
Crönlein, Moritz
Stemberger, Axel
van Griensven, Martijn
Lucke, Martin
Burgkart, Rainer
Obermeier, Andreas
author_facet Pförringer, Dominik
Harrasser, Norbert
Beirer, Marc
Crönlein, Moritz
Stemberger, Axel
van Griensven, Martijn
Lucke, Martin
Burgkart, Rainer
Obermeier, Andreas
author_sort Pförringer, Dominik
collection PubMed
description Calcium sulfate (CS) formulations are frequently implanted as antibiotically impregnated bone substitutes in orthopedic and trauma surgery to prevent or treat bone infections. Calcium ions have been discussed as candidates to accelerate blood coagulation. The goal of this study is to evaluate substance-specific influences of CS formulations on blood coagulation. Specific ELISAs were conducted to determine markers of activated blood coagulation after incubation of human blood with CS beads. Additionally, wettability with freshly drawn human blood was measured. Three different types of CS bone substitute beads were compared (CS dihydrate with tripalmitin, containing Gentamicin (Herafill(®)-G: Group A) or Vancomycin (CaSO(4)-V: Group B); and a CS hemihydrate with Tobramycin (Osteoset(®): Group C)). Examinations were performed by ELISA assays for F(1+2), FXIIa and C3a. Our results prove that none of the CS preparations accelerated single specific assays for activated coagulation markers. This allows the conclusion that neither Herafill(®)-G (CaSO(4)-G) nor CaSO(4)-V alter haemostasis negatively. Blood samples incubated with Osteoset(®) display an elevated F(1+2)-activity. The addition of tripalmitin in Herafill(®)-G shifts the original into a significantly hydrophobic formulation. This was additionally proven by contact angle examination of the three substances with freshly drawn human blood, showing that acceleration of plasmatic coagulation is hindered by lipids and induced by surface effects caused by presence of rapidly soluble calcium ions in the Osteoset(®) preparation.
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spelling pubmed-60256282018-07-09 Influence of Absorbable Calcium Sulfate-Based Bone Substitute Materials on Human Haemostasis—In Vitro Biological Behavior of Antibiotic Loaded Implants Pförringer, Dominik Harrasser, Norbert Beirer, Marc Crönlein, Moritz Stemberger, Axel van Griensven, Martijn Lucke, Martin Burgkart, Rainer Obermeier, Andreas Materials (Basel) Article Calcium sulfate (CS) formulations are frequently implanted as antibiotically impregnated bone substitutes in orthopedic and trauma surgery to prevent or treat bone infections. Calcium ions have been discussed as candidates to accelerate blood coagulation. The goal of this study is to evaluate substance-specific influences of CS formulations on blood coagulation. Specific ELISAs were conducted to determine markers of activated blood coagulation after incubation of human blood with CS beads. Additionally, wettability with freshly drawn human blood was measured. Three different types of CS bone substitute beads were compared (CS dihydrate with tripalmitin, containing Gentamicin (Herafill(®)-G: Group A) or Vancomycin (CaSO(4)-V: Group B); and a CS hemihydrate with Tobramycin (Osteoset(®): Group C)). Examinations were performed by ELISA assays for F(1+2), FXIIa and C3a. Our results prove that none of the CS preparations accelerated single specific assays for activated coagulation markers. This allows the conclusion that neither Herafill(®)-G (CaSO(4)-G) nor CaSO(4)-V alter haemostasis negatively. Blood samples incubated with Osteoset(®) display an elevated F(1+2)-activity. The addition of tripalmitin in Herafill(®)-G shifts the original into a significantly hydrophobic formulation. This was additionally proven by contact angle examination of the three substances with freshly drawn human blood, showing that acceleration of plasmatic coagulation is hindered by lipids and induced by surface effects caused by presence of rapidly soluble calcium ions in the Osteoset(®) preparation. MDPI 2018-06-01 /pmc/articles/PMC6025628/ /pubmed/29865173 http://dx.doi.org/10.3390/ma11060935 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pförringer, Dominik
Harrasser, Norbert
Beirer, Marc
Crönlein, Moritz
Stemberger, Axel
van Griensven, Martijn
Lucke, Martin
Burgkart, Rainer
Obermeier, Andreas
Influence of Absorbable Calcium Sulfate-Based Bone Substitute Materials on Human Haemostasis—In Vitro Biological Behavior of Antibiotic Loaded Implants
title Influence of Absorbable Calcium Sulfate-Based Bone Substitute Materials on Human Haemostasis—In Vitro Biological Behavior of Antibiotic Loaded Implants
title_full Influence of Absorbable Calcium Sulfate-Based Bone Substitute Materials on Human Haemostasis—In Vitro Biological Behavior of Antibiotic Loaded Implants
title_fullStr Influence of Absorbable Calcium Sulfate-Based Bone Substitute Materials on Human Haemostasis—In Vitro Biological Behavior of Antibiotic Loaded Implants
title_full_unstemmed Influence of Absorbable Calcium Sulfate-Based Bone Substitute Materials on Human Haemostasis—In Vitro Biological Behavior of Antibiotic Loaded Implants
title_short Influence of Absorbable Calcium Sulfate-Based Bone Substitute Materials on Human Haemostasis—In Vitro Biological Behavior of Antibiotic Loaded Implants
title_sort influence of absorbable calcium sulfate-based bone substitute materials on human haemostasis—in vitro biological behavior of antibiotic loaded implants
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025628/
https://www.ncbi.nlm.nih.gov/pubmed/29865173
http://dx.doi.org/10.3390/ma11060935
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