Novel insights into vancomycin-loaded calcium sulfate and negative pressure wound therapy in preventing infections in open fractures

• Published in: Journal of orthopaedic surgery and research Vol. 19; no. 1; pp. 517 - 16
• Main Authors: Jia, Bei, Xue, Rui, Li, Jia, Guo, Jichao, Liu, Jianning
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 29.08.2024; BioMed Central; BMC
• Subjects: Adult; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Calcium Sulfate - administration & dosage; Calcium Sulfate - therapeutic use; Disease susceptibility; Ethylenediaminetetraacetic acid; Female; Fractures, Open - therapy; Genes; Health aspects; Humans; Infection; Infection control; Macrophage polarization; Macrophages; Male; Medical research; Medicine, Experimental; Middle Aged; Negative pressure wound therapy; Negative-Pressure Wound Therapy - methods; Open fractures; RNA; RNA sequencing; Scientific equipment and supplies industry; Staphylococcal infections; Staphylococcal Infections - prevention & control; Staphylococcus aureus; Staphylococcus aureus infections; Surgical Wound Infection - prevention & control; Vancomycin; Vancomycin - administration & dosage; Vancomycin - therapeutic use; Vancomycin-Loaded Calcium Sulfate; Wound Healing - drug effects; United States; United Kingdom; Macrophage polarization; Negative pressure wound therapy; M2; Open fractures; Staphylococcus aureus infections; Vancomycin-Loaded Calcium Sulfate
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-024-04931-5

Open fractures are challenging due to susceptibility to Staphylococcus aureus infections. This study examines the impact of Vancomycin-Loaded Calcium Sulfate (VLCS) and negative pressure wound therapy (NPWT) on macrophage behavior in enhancing healing and infection resistance. Both VLCS and NPWT were evaluated individually and in combination to determine their effects on macrophage polarization and infection resistance in open fractures. Through single-cell RNA sequencing, genomic expressions in macrophages from open fracture patients treated with VLCS and NPWT were compared to a control group. The analysis focused on MBD2 gene changes related to macrophage polarization. Remarkable modifications in MBD2 expression in the treatment group indicate a shift towards M2 macrophage polarization. Additionally, the combined treatment group exhibited greater improvements in infection resistance and healing compared to the individual treatments. This shift suggests a healing-promoting atmosphere with improved infection resilience. VLCS and NPWT demonstrate the ability to alter macrophage behavior toward M2 polarization, which is crucial for infection prevention in open fractures. The synergistic effect of their combined use shows even greater promise in enhancing outcomes in orthopedic trauma care.