Liu James X, Werner Jordan, Kirsch Thorsten, Zuckerman Joseph D, Virk Mandeep S
NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003.
J Bone Jt Infect. 2018 Aug 10;3(4):165-172. doi: 10.7150/jbji.26355. eCollection 2018.
Chlorhexidine gluconate (CHX) is widely used as a preoperative surgical skin-preparation solution and intra-wound irrigation agent, with excellent efficacy against wide variety of bacteria. The cytotoxic effect of CHX on local proliferating cells following orthopaedic procedures is largely undescribed. Our aim was to investigate the effects of CHX on primary fibroblasts, myoblasts, and osteoblasts. Cells were exposed to CHX dilutions (0%, 0.002%, 0.02%, 0.2%, and 2%) for either a 1, 2, or 3-minute duration. Cell survival was measured using a cytotoxicity assay (Cell Counting Kit-8). Cell migration was measured using a scratch assay: a "scratch" was made in a cell monolayer following CHX exposure, and time to closure of the scratch was measured. All cells exposed to CHX dilutions of ≥ 0.02% for any exposure duration had cell survival rates of less than 6% relative to untreated controls (p < 0.001). Cells exposed to CHX dilution of 0.002% all had significantly lower survival rates relative to control (p < 0.01) with the exception of 1-minute exposure to fibroblasts, which showed 96.4% cell survival (p = 0.78). Scratch defect closure was seen in < 24 hours in all control conditions. However, cells exposed to CHX dilutions ≥ 0.02% had scratch defects that remained open indefinitely. The clinically used concentration of CHX (2%) permanently halts cell migration and significantly reduces survival of fibroblasts, myoblasts, and osteoblasts. Further studies are required to examine and optimize CHX safety and efficacy when applied near open incisions or intra-wound application.
葡萄糖酸氯己定（CHX）作为术前手术皮肤准备溶液和伤口内冲洗剂被广泛使用，对多种细菌具有优异的抗菌效果。CHX对骨科手术后局部增殖细胞的细胞毒性作用在很大程度上尚未被描述。我们的目的是研究CHX对原代成纤维细胞、成肌细胞和成骨细胞的影响。将细胞暴露于CHX稀释液（0%、0.002%、0.02%、0.2%和2%）中1、2或3分钟。使用细胞毒性测定法（细胞计数试剂盒-8）测量细胞存活率。使用划痕试验测量细胞迁移：在CHX暴露后在细胞单层中制造一个“划痕”，并测量划痕闭合的时间。所有暴露于≥0.02% CHX稀释液的细胞，无论暴露时间长短，相对于未处理的对照，细胞存活率均低于6%（p < 0.001）。暴露于0.002% CHX稀释液的细胞，除了成纤维细胞暴露1分钟显示96.4%的细胞存活率（p = 0.78）外，相对于对照均具有显著较低的存活率（p < 0.01）。在所有对照条件下，划痕缺损在< 24小时内闭合。然而，暴露于≥0.02% CHX稀释液的细胞的划痕缺损一直未闭合。临床上使用的CHX浓度（2%）会永久性地阻止细胞迁移，并显著降低成纤维细胞、成肌细胞和成骨细胞的存活率。在开放切口附近或伤口内应用CHX时，需要进一步研究以检查和优化其安全性和有效性。
