Aksu Neslihan, Hiz V M Murat, Bilgili Mustafa, Düzgün Oktay, Aksu Taner, Dervişoğlu Sergülen
Istanbul Bilim Universitesi Ortopedi ve Travmatoloji Anabilim Dali.
Acta Orthop Traumatol Turc. 2007;41(3):225-32.
This study aimed to develop an alternative thermoinactivation method for biological inactivation of microscopic contamination on the cavity wall following curettage of local aggressive tumors. Hot saline irrigation was applied at various temperatures to bone cavity, with or without tourniquet on the extremity and temperature changes and local effects were investigated in vivo.
Bone cavities 12 cm3 in size were created in the condylar regions of the hind legs in nine female adult sheep. The cavities were irrigated by hot saline solution at 60, 70, 75, 80, or 100 degrees C, with and without the presence of a tourniquet, and the temperatures 1, 2, 3, and 10 mm distant to the cavity wall were recorded. The animals were sacrificed postoperatively at 2 days, 3 and 6 weeks, and 3 and 7 months for histologic studies.
The mean body temperature and temperature inside the bone prior to surgery were measured as 38.1 degrees C and 27.34 degrees C, respectively. Tourniquet application caused a mean decrease of 1.5 degrees C (range 1-2 degrees C) in bone temperature. The highest temperatures measured below 80 degrees C and at 80 degrees C were 55.5 degrees C and 62.5 degrees C in the cavity, and 40.5 degrees C and 42.5 degrees C in the bone, respectively. At 100 degrees C, the color of the bone together with the surrounding soft tissue and muscle tissue turned to yellow-brown-black, and the animal died on the second postoperative day. At temperatures <or=80 degrees C, the color of the bone and surrounding tissues appeared normal and no early complications were encountered. Histologic studies showed no bone marrow or bone necrosis at 60 degrees C, only bone marrow necrosis at 70 degrees C and 75 degrees C, and in addition to bone marrow necrosis, bone necrosis at 80 degrees C. At these temperatures no evidence for soft tissue necrosis were observed.
Our results show that, in order to achieve bone necrosis at 1-mm and 2-mm distances from the cavity wall, the optimum temperature for hot saline irrigations applied to the bone cavity is 80 degrees C.
本研究旨在开发一种替代热灭活方法，用于在刮除局部侵袭性肿瘤后对腔壁上的微小污染物进行生物灭活。将不同温度的热盐水冲洗骨腔，在肢体使用或不使用止血带的情况下，研究体内温度变化和局部影响。
在9只成年雌性绵羊的后腿髁区制造大小为12立方厘米的骨腔。用60、70、75、80或100摄氏度的热盐水溶液冲洗骨腔，使用或不使用止血带，并记录距腔壁1、2、3和10毫米处的温度。术后2天、3周和6周以及3个月和7个月处死动物进行组织学研究。
术前测量的平均体温和骨内温度分别为38.1摄氏度和27.34摄氏度。使用止血带导致骨温平均降低1.5摄氏度（范围为1-2摄氏度）。在80摄氏度及以下和80摄氏度时，腔内测量到的最高温度分别为55.5摄氏度和62.5摄氏度，骨内分别为40.5摄氏度和42.5摄氏度。在100摄氏度时，骨以及周围的软组织和肌肉组织颜色变为黄棕黑，动物在术后第二天死亡。在温度≤80摄氏度时，骨和周围组织颜色正常，未出现早期并发症。组织学研究显示，60摄氏度时无骨髓或骨坏死，70摄氏度和75摄氏度时仅有骨髓坏死，80摄氏度时除骨髓坏死外还有骨坏死。在这些温度下未观察到软组织坏死的证据。
我们的结果表明，为了在距腔壁1毫米和2毫米处实现骨坏死，应用于骨腔的热盐水冲洗的最佳温度为80摄氏度。
