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Biofilm Management: Attack the Matrix with Ultrasound
Mark Granick, M.D.1, Chaitra Parthiban, MS2, Mayilvahanan Shanmugam, PhD2, Narayanan Ramasubbu, PhD2.
1Rutgers New Jersey Medical School, Newark, NJ, USA, 2Rutgers New Jersey Dental School, Newark, NJ, USA.

PURPOSE: Implant infections are highly morbid and costly. Staph species are the primary agents. Despite extensive efforts, satisfactory treatment is elusive, largely due to the persistence of biofilm. Ultrasound is a known biofilm disrupter. A new low frequency direct contact ultrasound (LFDCU) device is available for wound debridement. This study is meant to determine if the energy levels available in this instrument are effective in dispersing biofilm.
METHODS: Staph. epidermidis biofilm was grown on one centimeter diameter metallic discs of both medical grade stainless steel and titanium. The discs were treated in wells with the LFDCU for ten seconds at a three different power levels. The discs were stained with crystal violet and effluent was cultured. The study was repeated with hypochlorous acid as the device irrigant. Controls were performed.RESULTS: Biofilm was completely removed at all power levels. With saline irrigant, the effluent had viable planktonic bacteria. With hypochlorous acid irrigant, the effluent was sterile.
CONCLUSION:
The new LFDCU completely disperses biofilm from metallic discs at all energy levels. This suggests that biofilm can potentially be cleared from infected metallic implants even at low energy levels. In such cases, hypocholous acid device irrigation can remove any loosened bacteria.


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