Medica 2018

•••9••• Innovationen H ip and dental implant opera- tions are routine but not en- tirely risk-free. They may result in infection that is difficult to control with oral or intravenous antibiot- ics. In such cases, the implant will probably need to be replaced. Fraunhofer researchers can now apply a precisely matched drug di- rectly to the replacement implant while significantly increasing the effectiveness of the antibiotic via a synergism with silver ions. Their research will be on display at the Medica and Compamed trade fairs in Düsseldorf from November 12 to 15, 2018 (Hall 8a, Booth P13). Every step is painful – there’s no getting around a new artificial hip joint. But such operations carry the risk of bacteria getting into the wound and developing into severe infections. Normally these are treated with antibiotics. How- ever, some germs are resistant to certain antibiotics, and adminis- tering a strong enough dose of oral or intravenous antibiotics to eliminate all the pathogens on the implant is often impossible. The implant becomes unstable and needs to be replaced. Just how can another infection be avoided? As part of the “Synergy-Boost” project, researchers at the Fraun- hofer Institutes for Manufacturing Technology and Advanced Materi- als (IFAM), for Molecular Biology and Applied Ecology (IME), for Cell Therapy and Immunology (IZI), and for Toxicology and Experi- mental Medicine (ITEM) have to- gether developed a technique for preventing further infection. “We apply the antibiotic needed direct- ly to the second implant – bring- ing it right to the spot where it’s needed,” says Kai Borcherding, a scientist at Fraunhofer IFAM. “We also did research on how antibiot- ics and silver ions work synergisti- cally, significantly increasing the efficacy of the drug.” While both the antibiotic and the silver ions can eliminate pathogens, their combined effect is much stronger than the sum of their individual ef- fects – they reinforce each other. Silver ions have long been known to substantially enhance the ef- fect of antibiotics, but research into the mechanism has been lim- ited to isolated experiments. The optimal ratio of silver ions to antibiotic molecules is depend- ent not only on the drug used, but also on which microorganism is to be killed. The researchers at Fraunhofer IME initially per- formed large-scale screenings. They investigated 20 different antibiotics with various ratios of silver ions and on four key patho- gens – a total of more than 9000 tests – to identify the most effec- tive combinations. If patients suf- fer from an infection and need a new hip joint or a new dental im- plant, the first thing the physician will do is to generate an antibio- gram. Suitable sample material is taken, the microorganisms from it are cultivated and then analyzed to identify the appropriate antibi- otic. This is a standard procedure. The physician then applies the ap- propriate antibiotic directly to the implant. “At Fraunhofer IFAM, we have already investigated how the antibiotics can be stored,and de- veloped various coating methods to do this,” says Borcherding. The researchers have found a way to structure the surface so that it absorbs the antibiotic. In a vacuum, they apply the coating containing silver to the surface of the implant. Development of the coating process is now complete. Researchers at Fraunhofer IZI and Fraunhofer ITEM must now verify its efficacy. Scientists at Fraun- hofer ITEM are also preparing the documentation required for ap- proval of medical devices. Synthesizing new antibiotics The researchers in the “Synergy- Boost” project are also attempt- ing to answer a further question: Which natural substances from plants or trees might be suitable for synthesizing new antibiotics? The first results from Fraunhofer IZI are promising, but it will take several years before such antibiot- ics are ready for clinical trials. The scientists will be demonstrat- ing implant surfaces from their research at the Medica and Com- pamed trade fairs in Düsseldorf from November 12 to 15, 2018 (Hall 8a, Booth P13). No chance for bacteria on implants Researchers can now apply a precisely matched drug directly to the replacement implant Antibiotic coating lyses bacterium (E. coli) Photo: Fraunhofer IFAM Anzeige Miniature, efficient and intelligent implantable actuators MPS Microsystems, a subsidiary of the German FAULHABERGROUP, develops miniaturized implantable actuators that support the functions of human body organs. Featuring low energy consumption, these actua- tors are equipped with an intelligent wireless data transmission and power transfer system. Energy efficiency at the heart of design considerations Wireless connections between an implanted active Medical Device and its external control system are increasingly popular and almost mandatory in any new develop- ment. However, the power and ca- pacity of implantable batteries and the low permissible powers through living tissues considerably limit the mechanical performance of im- planted Medical Devices. When the specifications of the implemented Medical Devices require powers at the limit of what the currently available energy sources can pro- vide, the only element the engineer can focus on is minimizing losses along the entire energy transmis- sion chain. It is precisely in this field that MPS Microsystems applies its expertise, thanks to several decades of challenges taken up on behalf of its customers in order to provide them with systems that are ever smaller, ever more efficient and ever less en- ergy-intensive. Over the years, MPS’ “toolbox” has grown with proven tips that its engineers combine to create optimal solutions. An extensible, high-performance, integrated and intelligent in- tramedullary nail Examples of optimization of energy transmission technologies by MPS Microsystems include an intramed- ullary nail developed by the company. This nail integrates the electromag- netic wave receiving antenna, elec- tronics, energy storage, motorization, as well as mechanical transmission for elongation. The major challenge of this development was to generate an extension force of 1,200Nwith an available power of 15mW inside the implant. MPS Microsystems’ implantable miniaturized actuators also have ap- plications in the field of urinary in- continence and heart surgery. Today, MPS has developed implant- able actuators for forces ranging from 10 to 1’200N. Hall 8b, Booth M27