JBJI Journal of Bone and Joint Infection JBJI J. Bone Joint Infect. 2206-3552 Ivyspring Göttingen, Germany 10.7150/jbji.22121 Effects of Local Application of Nano-silver on Osteomyelitis and Soft Tissue Infections: An Experimental Study in Rats Kemah Bahattin 1 Uzer Gökçer 2 Turhan Yalçın 3 Özturan Burak 4 Kılıç Bülent 5 Gültepe Bilge Sümbül 6 Ceyran Ayşe Bahar 7 Ertürk Selim 8 Aksoylu Burak 8 Şenaydın Özlem 9 Özkan Korhan 10 Orthopedics and Traumatology Department, Ağrı State Hospital, Ağrı, Turkey. Orthopedics and Traumatology Department, Bezmialem University Medical Faculty, Istanbul, Turkey. Orthopedics and Traumatology Department, Duzce University Medical Faculty, Duzce, Turkey. Orthopedics and Traumatology Department, Nizip State Hospital, Gaziantep, Turkey. Orthopedics and Traumatology Department, Gelişim University Faculty of Health Sciences, Istanbul, Turkey Microbiology Department, Bezmialem University Medical Faculty, Istanbul, Turkey. Pathology Department, Medeniyet University Medical Faculty, Istanbul,Turkey. Metallurgical Engineering Department, İstanbul Technical University Engineering, Istanbul, Turkey. Microbiology Department, Medeniyet University Medical Faculty, Istanbul,Turkey. Orthopedics and Traumatology Department, Medeniyet University Medical Faculty, Istanbul,Turkey. 12 04 2018 3 1 43 49 Copyright: © 2018 Bahattin Kemah et al. 2018 This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/ This article is available from https://jbji.copernicus.org/articles/3/43/2018/jbji-3-43-2018.html The full text article is available as a PDF file from https://jbji.copernicus.org/articles/3/43/2018/jbji-3-43-2018.pdf

<p class="p p-first" id="__p2"><strong>Purpose</strong>: Bone and soft tissue infections are among the least desired complications after orthopaedic surgery. This study analysed the <em>in vivo</em> effects of the local application of nano-silver particles (AgNPs) [1nm = 1 billionth of a meter] in soft tissue infections.</p><p id="__p3"><strong>Materials-Method</strong>: An experimental osteomyelitis model was formed by inoculating both tibias of 24 rats with methicillin-resistant <em>Staphylococcus aureus</em>. The rats were followed without treatment for 21 days. Blood samples and tibial x-rays at day 21 confirmed the development of infection. Then, the rats were divided randomly into two groups. One group (12 rats) underwent surgical debridement and received 21 days of teicoplanin therapy. The second group had the same treatment, with the addition of local nano-silver. All of the rats were sacrificed at day 42. Blood and wound swab samples were taken and the culture results were analysed.</p><p id="__p4"><strong>Results</strong>: No differences were observed between the groups in healing values at pathological examination, or in changes in the number of colonies at days 21 and 42. No differences in white blood cell count (WBC) were observed between the groups before and after the treatment.</p><p class="p p-last" id="__p5"><strong>Conclusion</strong>: Although <em>in vitro</em> studies suggest the effectiveness of AgNPs on pathogens, we found that the application of nano-silver did not make any difference when used in addition to the classical osteomyelitis treatment with antibiotics and local surgical debridement. We believe that additional <em>in vivo</em> studies using repeated nano-silver application could be beneficial.</p>

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