Silver-coated Tumorendoprothesen - a proof of the anti-infectious qualities and exclusion of toxic side effects.

Deep infection ofmegaprostheses remains a serious complication in orthopedic tumor surgery. Despite the use ofsystemic and local antibiotic prophylaxis the reported infection rate is between 5% and 35%. Silver-coated medical devices proved their effectiveness in reducing infections. The objective of this study was to examine in vivo the antimicrobial efficacy and possible sideeffects of a silver-coated megaprosthesis. In a first study, 30 rabbits (15 titanium versus 15 silver-coated Mutarss—endoprostheses) were infected with Staphylococcus aureus. In a second study, toxicological side effects were analyzed in 10 rabbits with a silvercoated megaprosthesis.

The silver group showed significantly (po0.05) lower infection rates (7% versus 47%) in comparison with the titanium group. Measurements ofthe C-reactive-protein, neutrophilic leukocytes, rectal temperature and body weight showed significant (po0.05) lower signs ofinflammation in the silver group. The analysis ofthe silver concentration in blood (median 1.883 ppb) and in organs (0.798–86.002 ppb) showed elevated silver concentrations without pathologic changes in laboratory parameters and without histological changes oforgans. In conclusion, the new silver-coated Mutarss—megaprosthesis resulted in reduced infection rates without toxicological side effects, suggesting that this prosthesis might be a promising device in tumor surgery exhibiting antimicrobial activity.