2. Academic Validation
  3. Propellant-free intrawound antibiotic foam for intraoperative antimicrobial prophylaxis

Propellant-free intrawound antibiotic foam for intraoperative antimicrobial prophylaxis

  • Drug Deliv Transl Res. 2026 Jul;16(7):2514-2526. doi: 10.1007/s13346-026-02138-1.
Christina Karavasili 1 2 3,  Ian D Connolly 4,  Sanghyun Park 1 2 5,  Hannah Boyce 1 2,  Charmaine Chang 2,  Ashley Guevara 1,  Joshua Morimoto 1,  Niora Fabian 1 5 6,  Miguel Jimenez 1 2 5,  Golda S Gershanok 7,  Ganesh M Shankar 4,  Giovanni Traverso 8 9 10 11
Affiliations

Affiliations

  • 1 David H. Koch Institute for Integrative Cancer Research, Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
  • 2 Division of Gastroenterology Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02139, USA.
  • 3 Department of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece.
  • 4 Department of Neurosurgery, Mass General Brigham, Boston, MA, USA.
  • 5 Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
  • 6 Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
  • 7 Harvard-MIT Division of Health Science Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
  • 8 David H. Koch Institute for Integrative Cancer Research, Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA. [email protected].
  • 9 Division of Gastroenterology Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02139, USA. [email protected].
  • 10 Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA. [email protected].
  • 11 Broad Institute of MIT and Harvard, Cambridge, MA, 02139, USA. [email protected].
PMID: 42050315 DOI: 10.1007/s13346-026-02138-1
Abstract

Intrawound vancomycin powder is the most widely used intraoperative prophylactic intervention against surgical site infections (SSIs). However, applying raw drug powder to irregular or small surgical cavities can result in uneven wound coverage, drug precipitation, and airborne drug particles. To address these issues, we developed a surfactant-based aqueous foam specifically for spine surgery, where deep incisions and instrumentation heighten SSI risks. A rat model of spinal implant-associated Staphylococcus aureus Infection was developed to assess the antimicrobial efficacy of intrawound vancomycin foam. The compatibility of the blank foam and the antimicrobial efficacy of the vancomycin foam were assessed in vivo in Sprague Dawley rats. Biocompatibility was evaluated by applying the foam, dispensed from a propellant-free pump device to the dorsal spine wound bed. The antimicrobial efficacy of the vancomycin foam was evaluated through exposure of the dorsal spine of the Animals, foreign body implantation and S. aureus inoculation, with comparisons made to vancomycin powder-treated and untreated groups. Using a propellant-free pump device delivers the foam easily, ensuring uniform coverage and drug retention without leaving any solid residues. The foam formulation significantly increases vancomycin solubility compared to water alone. In a rat model of spinal implant-associated Staphylococcus aureus Infection, the vancomycin foam demonstrated antimicrobial efficacy comparable to the vancomycin powder, with no observed soft tissue damage or systemic toxicity. Here, we have demonstrated that propellant-free aqueous foams can be an effective and simple alternative to intrawound vancomycin powder for preventing SSIs in spine surgery.

Keywords

Staphylococcus aureus; antibiotic prophylaxis; intrawound vancomycin; propellant-free foam; spine surgery; surgical site infections.

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