Kaysinger K K, Nicholson N C, Ramp W K, Kellam J F
Baxter Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina 28232-2861, USA.
J Orthop Trauma. 1995;9(4):303-11. doi: 10.1097/00005131-199509040-00006.
Irrigating wounds with solutions of antiseptic or antibiotic agents is routinely performed in orthopaedic surgery to reduce the incidence of microbial infection. The effects of these agents on healthy bone tissue is unknown. Three commonly employed antiseptic agents (hydrogen peroxide, Betadine solution, Betadine scrub) and one antibiotic solution (bacitracin) were tested on tibiae and osteoblasts isolated from embryonic chicks. Osteoblast function was evaluated by glycolytic energy metabolism (lactate production), cell number (DNA content), and collagen synthesis ([3H]proline hydroxylation). Two series of experiments were performed. To study concentration-related effects, tibiae or cells were exposed to a range of concentrations of the agents (diluted in saline, 0.9% NaCl) for 2 min, rinsed with saline, and incubated for 24 h in medium containing [3H]proline. For the recovery study, the cells were exposed to an effective, but nonlethal, concentration of the antiseptic agents for 2 min, rinsed with saline, and the incubation was continued in complete culture medium for 6, 12, 24, 48, or 72 h with [3H]proline added for the final 6 h. Solutions containing the antiseptic agents were cytotoxic to both bones and cells at concentrations well below those used clinically in irrigation solutions. In contrast, bacitracin at the concentrations tested was safe for osteoblasts and tibiae. These results suggest that the use of irrigation solutions containing H2O2, Betadine solution, or Betadine scrub on exposed bone tissue should be considered with caution.
在骨科手术中，常规使用防腐剂或抗生素溶液冲洗伤口以降低微生物感染的发生率。这些药剂对健康骨组织的影响尚不清楚。对从胚胎小鸡分离出的胫骨和成骨细胞测试了三种常用的防腐剂（过氧化氢、聚维酮碘溶液、聚维酮碘擦洗剂）和一种抗生素溶液（杆菌肽）。通过糖酵解能量代谢（乳酸产生）、细胞数量（DNA含量）和胶原蛋白合成（[3H]脯氨酸羟化）评估成骨细胞功能。进行了两个系列的实验。为了研究浓度相关效应，将胫骨或细胞暴露于一系列浓度的药剂（用生理盐水、0.9%氯化钠稀释）中2分钟，用生理盐水冲洗，然后在含有[3H]脯氨酸的培养基中孵育24小时。对于恢复研究，将细胞暴露于有效但非致死浓度的防腐剂中2分钟，用生理盐水冲洗，然后在完全培养基中继续孵育6、12、24、48或72小时，在最后6小时添加[3H]脯氨酸。含有防腐剂的溶液在远低于临床冲洗溶液所用浓度时对骨骼和细胞均具有细胞毒性。相比之下，在所测试的浓度下，杆菌肽对成骨细胞和胫骨是安全的。这些结果表明，在暴露的骨组织上使用含有H2O2、聚维酮碘溶液或聚维酮碘擦洗剂的冲洗溶液时应谨慎考虑。
