human osteoblasts; antiseptics; chlorhexidine; polyhexanide; periprosthetic joint infection
610 Medizin und Gesundheit
Purpose. Antiseptics are a powerful medical agent used for wound treatment and decontamination and have a high potential for defeating joint infections in septic surgery. Both chlorhexidine and polyhexanide are frequently used in clinical practice and have a broad antimicrobial range, but their effect on human osteoblasts has not been sufficiently studied before. Our objective was to investigate the toxic effects of polyhexanide and chlorhexidine on human osteoblasts in vitro for evaluating their clinical applicability in septic surgery.
Methods. We isolated and cultivated human osteoblasts in vitro and assayed the toxic effects of chlorhexidine 0.1% and polyhexanide 0.04%, concentrations commonly applied in clinical practice. Toxicity was evaluated by microscopic inspection of cell morphology, trypan blue staining, evaluation of vital cell counts and determination of LDH-release.
Results. Damaged cell structure could be shown by microscopy. Both antiseptics promoted LDH activity after incubation with osteoblasts. The evaluation of vital osteoblasts showed a significant decrease of vital cells.
Conclusions. Both antiseptics induced significant cell death of osteoblasts at exposure optimum. Thus we recommend a cautious use of polyhexanide and chlorhexidine in septic surgery to avoid severe osteoblast toxicity.
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