Gary Ko, MD, Darren Siu, BScH, Lewis Tomalty, PhD, David Robertson, MD. Queen’s University
INTRODUCTION: Previous studies have demonstrated that local anesthetics have antimicrobial effects, but there have been none looking at these effects on hernia mesh.
METHODS: The minimum inhibitory concentration (MIC) of lidocaine, bupivacaine, and cefazolin were determined on strains of methicillin-sensitive and methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis using a micro broth dilution method. The agents were then introduced in combination with an anti-adhesive coated polypropylene mesh to determine changes to the MIC. The fractional inhibitory concentration (FIC) index for each agent was calculated to determine whether if the changes seen were additive or synergistic.
RESULTS: Lidocaine did not exert an antimicrobial effect on S. aureus or S. epidermidis. Bupivacaine and cefazolin each produced inhibitory effects on these organisms. The introduction of the coated polyproylene mesh eliminated the antimicrobial effect of bupivacaine, but the antimicrobial effect of cefazolin was unaltered. An additive effect was noted when bupivacaine and cefazolin were used together on methicillin-sensitive S. aureusand S. epidermis. A synergistic effect was seen when bupivacaine and cefazolin were used together on methicillin-resistant S. aureus and S. epidermis. Furthermore, these effects were preserved in the presence of mesh.
CONCLUSION: Local anesthetics exhibit varying degrees of antimicrobial activity. This effect was synergistic when used with cefazolin on methicillin-resistant organisms and was preserved when used with coated polypropylene mesh.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87048
Program Number: P038
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster