Röhner Eric, Seeger Joern B, Hoff Paula, Dähn-Wollenberg Stephanie, Perka Carsten, Matziolis Georg
Department of Traumatology and Orthopedics, and Dr Hoff is from the Department of Rheumatology and Clinical Immunology, Charité--Universitätsmedizin, Berlin, Germany.
Orthopedics. 2011 Jul 7;34(7):e290-4. doi: 10.3928/01477447-20110526-02.
The treatment of acute joint infections has an important impact on long-term outcome and remains an unsolved problem. The most frequent bacteria are staphylococci, streptococci, and gram-negative bacteria. In septic surgery, polyhexanide and hydrogen peroxide are the most frequently used local antiseptics. The aim of this study was to examine the hypothesis that antiseptics induce cell death of human chondrocytes after a short incubation time.Human chondrocytes were treated with different concentrations of polyhexanide and hydrogen peroxide. Toxicity analysis was determined by visualization of cell structure using light microscopy, lactate dehydrogenase release, and determination of living and total cell numbers after addition of polyhexanide and hydrogen peroxide. Light microscopic data revealed a defect cell structure after addition of both antiseptics. Lactate dehydrogenase activity showed a significant increase of enzyme expression after a short incubation with polyhexanide. The determination of vital chondrocytes showed a significant decrease of vital and total cell numbers after addition with polyhexanide and hydrogen peroxide.Both antiseptic solutions induce significant cell death of human chondrocytes after a short incubation time. Polyhexanide possibly has more toxic potential than hydrogen peroxide against human chondrocytes after an application >15 minutes. Therefore, both substances should only be applied for a short time (<15 minutes) and the joint irrigated to wash out the antiseptic substance prior to wound closure.
急性关节感染的治疗对长期预后有重要影响，且仍是一个未解决的问题。最常见的细菌是葡萄球菌、链球菌和革兰氏阴性菌。在脓毒症手术中，聚己缩胍和过氧化氢是最常用的局部防腐剂。本研究的目的是检验以下假设：防腐剂在短时间孵育后会诱导人软骨细胞死亡。用人软骨细胞分别用不同浓度的聚己缩胍和过氧化氢处理。通过光学显微镜观察细胞结构、检测乳酸脱氢酶释放以及在添加聚己缩胍和过氧化氢后测定活细胞数和总细胞数来进行毒性分析。光学显微镜数据显示，添加两种防腐剂后细胞结构出现缺陷。乳酸脱氢酶活性显示，与聚己缩胍短时间孵育后酶表达显著增加。活软骨细胞的测定显示，添加聚己缩胍和过氧化氢后活细胞数和总细胞数显著减少。两种防腐剂溶液在短时间孵育后均会诱导人软骨细胞显著死亡。在应用超过15分钟后，聚己缩胍对人软骨细胞的毒性可能比过氧化氢更大。因此，两种物质都应仅短时间应用（<15分钟），并且在伤口闭合前对关节进行冲洗以洗去防腐剂。
