Research issues
Modern surgery often involves the use of devices made from biomaterials. These are prone to a particular type of infection, in which the research group has a special interest. Such surgery includes neurosurgery, critical care, trauma, spinal and orthopaedic surgery, ear infections, dialysis for kidney failure, and longterm bladder drainage.
Our research involves the causes of surgical infection, how to diagnose and treat it more efficiently, and importantly how to prevent it. Much of our research is on development of antimicrobial materials for surgical use and we already have some of these in clinical use.
What we are doing about...
1. Causes of surgical infection
We are carrying out research to optimize preoperative skin disinfection, and we are also reviewing the antibiotics currently used for prophylaxis. More basic research involves investigation of infections caused by bacterial biofilms. Some of these require special approaches such as anaerobic conditions.
2. Orthopaedic infections
Elective surgery such as for hip or knee replacement depends heavily of antibiotics but we are working with our orthopaedic colleagues to investigate better ways to deliver these, both form prevention and for treatment when an infection occurs. We are also researching faster, better ways of diagnosing infection in these procedures. Bone trauma is often contaminated with bacteria and we are investigating ways of dealing with this rapidly and effectively, to cut time in hospital while improving outcomes for patients. Some of this work involves biodegradable polymers.
3. Neurosurgical infections
We have carried out extensive research in this area and we have published on their causes, diagnosis, treatment and prevention. We have patented an antimicrobial neurosurgical device for hydrocephalus treatment and neurocritical care that has been used in almost 1 million patients worldwide with a significant reduction in infection rate.
Otitis media with effusion (OME) is common in children and can lead to chronic illness and deafness. We have clarified its cause and we are now collaborating with otolaryngologists to investigate ways of treating it to increase first-time success rates. Part of this research, at a very early stage, involves the use of magnetic nanoparticles.
Used to treat kidney failure, this form of dialysis carries a risk of abdominal infection. We have developed an antimicrobial dialysis catheter that can kill bacteria for 2-3 months, offering a way of making this treatment much safer and more effective. The catheter is licensed to a large company and is currently undergoing CE-marking before clinical use.
6. Longterm urinary catheters
Catheterization of the bladder is necessary for very long periods after spinal injury, some strokes and other debilitating conditions, and patients rarely escape bladder infections and incapacitating complications. We have collaborated with Professor Morgan Alexander’s group on discovery of anti-adhesive polymers to reduce infection, the subject of a paper in Nature Biotechnology. We have also developed an antimicrobial catheter that gives antimicrobial activity for 2-3 months and promises a much – improved quality of life for catheter users.
Current projects
- Prevention of external fixator pin site infection with a novel antibiotic-impregnated collar (J Walker, R Bayston, B Scammell, Arthritis Research UK Fellowship 2010)
- Efficacy of pre-operative patient skin preparation using Chloraprep (R Bayston, B Scammell, Waheed Ashraf, Lisa Whittington)
- Suitablility of current antibiotic prophylaxis for neck of femur fractures and arthroplasty (R Bayston, B scammell, W Ashraf, Jenny Paterson)
- All projects
Outcomes
Patent
Professor Bayston has established the clinical and commercial viability of the platform technology and his strong interest in antimicrobial biomaterials has resulted in a patented process which has been used to develop a clinically successful "anti-infective" hydrocephalus shunt, with over 150,000 recipients worldwide, and a device for neurocritical care with over 750,000 patients worldwide.
Further developments are under way to address infection in orthopaedics, neurosurgery, peritoneal and haemodialysis, renal medicine and in patients using central venous access devices. A second patent in this area has now been filed in several countries and has been granted in some.
Having for antimicrobial neurosurgical implants, we have now extended this to include broader spectrum antimicrobial catheters for external ventricular drainage in neurocritical care, dialysis catheters and an antimicrobial longterm urinary catheter with activity for more than 80 days.
Publications in leading peer-reviewed journals
Our research has been published in leading journals. Please see publications records under the individual profiles of our members.