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High-Throughput Assay for Bacterial Adhesion on Acellular Dermal Matrices and Synthetic Surgical Materials

Nyame, Theodore T. M.D.; Lemon, Katherine P. M.D., Ph.D.; Kolter, Roberto Ph.D.; Liao, Eric C. M.D., Ph.D.

Plastic and Reconstructive Surgery: November 2011 - Volume 128 - Issue 5 - p 1061–1068
doi: 10.1097/PRS.0b013e31822b65af
Experimental: Original Articles

Background: There has been increasing use of synthetic and acellular dermal matrix materials in surgery, ranging from breast reconstruction to hernia repairs. There is a paucity of data on how acellular dermal matrix compares with other surgical materials as a substrate for bacterial adhesion, the first step in formation biofilm, which occurs in prosthetic wound infections. The authors have designed a high-throughput assay to evaluate Staphylococcus aureus adherence on various synthetic and biologically derived materials.

Methods: Clinical isolates of S. aureus (strains SC-1 and UAMS-1) were cultured with different materials, and bacterial adherence was measured using a resazurin cell vitality assay. Four materials that are commonly used in surgery were evaluated: Prolene mesh, Vicryl mesh, and two different acellular dermal matrix preparations (AlloDerm and FlexHD). The authors were able to develop a high-throughput and reliable assay for quantifying bacterial adhesion on synthetic and biologically derived materials.

Results: The resazurin vitality assay can be reliably used to quantify bacterial adherence to acellular dermal matrix material and synthetic material. S. aureus strains SC-1 and UAMS-1 both adhered better to acellular dermal matrix materials (AlloDerm versus FlexHD) than to the synthetic material Prolene. S. aureus also adhered better to Vicryl than to Prolene. Strain UAMS-1 adhered better to Vicryl and acellular dermal matrix materials than did strain SC-1.

Conclusions: The results show that S. aureus adheres more readily to acellular dermal matrix material than to synthetic material. The resazurin assay provides a standard method for evaluating surgical materials with regard to bacterial adherence and potential propensity for biofilm development.

Boston, Mass.

From the Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School; the Center for Regenerative Medicine, Harvard Stem Cell Institute; the Division of Infectious Diseases, Children's Hospital Boston, Harvard Medical School; and the Department of Microbiology and Molecular Genetics, Harvard Medical School.

Received for publication October 12, 2010; accepted May 6, 2011.

Disclosure:The authors have no commercial associations or financial interests to disclose.

Eric C. Liao, M.D., Ph.D.; Plastic and Reconstructive Surgery, Center for Regenerative Medicine, Massachusetts General Hospital, WACC 435, 15 Parkman Street, Boston, Mass. 02114-3117,

©2011American Society of Plastic Surgeons