氯己定浸泡对严重污染骨的时间依赖性影响。

Time-dependent effects of chlorhexidine soaks on grossly contaminated bone.

机构信息

Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Ft Sam Houston, TX 78234, USA.

出版信息

J Orthop Trauma. 2012 Oct;26(10):574-8. doi: 10.1097/BOT.0b013e31824a3aad.

DOI:10.1097/BOT.0b013e31824a3aad

PMID:22473065

Abstract

OBJECTIVE

The purpose of this study was to quantify the reduction in the bacterial burden of grossly contaminated bone segments using different chlorhexidine (CHL) solutions. We hypothesized that 4% CHL would be the most efficient decontaminate.

METHODS

Fifty-four bone segments were harvested from fresh-frozen porcine legs. Each specimen was dropped onto a Mueller-Hinton medium that was inoculated with Staphylococcus aureus (lux). These genetically engineered bacteria emit photons in proportion to their number, allowing for quantification. The segments were retrieved after 5 seconds of exposure. Baseline imaging provided the initial bacterial load. An equal number of specimens were soaked in normal saline (NS), 2%CHL, or 4%CHL. Specimen reimaging was completed at the 5-, 10-, 20-, 30-, and 60-minute marks.

RESULTS

The average bacterial count on the bone segments were 2.18 × 10(7) for NS, 2.31 × 10(7) for 2%CHL, and 2.00 × 10(7) for 4%CHL. The percent reduction in bacterial counts at the 5-, 10-, 20-, 30-, and 60-minute marks were NS: 0%, 0%, 0%, 29.84%, 72.23%; 2%CHL: 93.09%, 98.16%, 99.21%, 99.63%, 99.81%; 4%CHL: 94.32%, 97.60%, 99.25%, 99.63%, 99.82%. At all time intervals, there was a significant difference between the 2%CHL and 4%CHL groups compared with the NS group (P < 0.0001) and no difference between the 2%CHL and 4%CHL groups.

CONCLUSIONS

This study provides new data supporting the use of CHL to decontaminate grossly soiled bone segments. To maximize efficiency and decrease potential untoward effects, the authors recommend 20-minute soaks using 2% CHL for contaminated bone segments.

摘要

目的

本研究旨在量化使用不同浓度洗必泰（CHL）溶液对严重污染的骨段细菌负荷的减少。我们假设 4%CHL 将是最有效的去污剂。

方法

从新鲜冷冻的猪腿中采集 54 个骨段。每个标本在接种金黄色葡萄球菌（lux）的 Mueller-Hinton 培养基上掉落 5 秒钟。这些经过基因改造的细菌会根据其数量发射光子，从而进行定量。暴露 5 秒后取回标本。基线成像提供了初始细菌负荷。相同数量的标本分别浸泡在生理盐水（NS）、2%CHL 或 4%CHL 中。在 5、10、20、30 和 60 分钟时进行标本重成像。

结果

NS 组骨段的平均细菌计数为 2.18×10(7)，2%CHL 组为 2.31×10(7)，4%CHL 组为 2.00×10(7)。5、10、20、30 和 60 分钟时细菌计数减少的百分比为 NS：0%、0%、0%、29.84%、72.23%；2%CHL：93.09%、98.16%、99.21%、99.63%、99.81%；4%CHL：94.32%、97.60%、99.25%、99.63%、99.82%。在所有时间间隔内，与 NS 组相比，2%CHL 和 4%CHL 组之间均有显著差异（P<0.0001），而 2%CHL 和 4%CHL 组之间无差异。