Cytotoxic effect of sodium hypochlorite (Lavanox 0.08%) and chlorhexidine gluconate (Irrisept 0.05%) on human osteoblasts

Abstract

Purpose Soft tissue, bone and joint infections are severe complications in orthopedic and traumatological surgery. Lavanox (0.08% NaOCl) and Irrisept (0.05% chlorhexidine gluconate, CHG) are industrially produced antiseptic solutions commonly used in infection treatment. Regarding this clinical indication, the microbicidal effect is often investigated, but toxicity to osteoblasts has rarely been examined. This is important to decide whether these solutions should be used in septic situations in which bone healing must take place. The hypothesis of the present study is that NaOCl and CHG are cytotoxic to osteoblasts even after a short exposure time. Methods Human osteoblasts were isolated from donors with osteoarthritis during total knee and hip arthroplasty. Cells were cultivated and treated with both antiseptic solutions for 2, 5 and 10 min in different dilutions. Toxicity was quantified by counting cells, lactate dehydrogenase (LDH) expression, spectrophotometric quantification via XTT assay and FDA/PI fluorescence microscopy. Results Analyzing viable cells after treatment with both antiseptics showed a significant decrease in viable cells through LDH expression test, XTT assay, fluorescence microscopy and light microscopy, depending on concentration. The time dependence showed a trend to more cell death at longer exposure times, without significance. Conclusion Toxic effects on osteoblasts were shown after treatment with 0.08% NaOCl and 0.05% CHG after an exposure time of 2 min which also was concentration dependent. There was no difference in cytotoxicity between both antiseptics. In conclusion, these antiseptic solutions may be used with caution in situations requiring bone healing. Trial registration number Local ethics committee registration number: 5176–07/16

A review of current practices in periprosthetic joint infection debridement and revision arthroplasty

“…The ongoing debate as to whether solutions such as betadine are superior to chlorhexidine gluconate-based solutions illustrates the useful adjunct that intra-articular irrigation plays. In choosing which solution is superior, most agree that it should be capable of penetrating the biofilm that is a hallmark of chronic PJI, while remaining minimally-cytotoxic to host tissue that will prove crucial towards the inevitable lengthy healing process [56][57][58][59]. In addition to the contents of the irrigating solution, there has been significant discussion regarding appropriate irrigation pressure and duration.…”

Antimicrobial and Antiproliferative Effects of Zingiberaceae Oils: A Natural Solution for Oral Health

“…[2] The oral care market has shown a substantial increase in revenue with an estimated cumulative annual growth rate of 8.1 % yearly, whereby mouthwash products recorded the highest, followed by toothpaste. [3] Concerns about the chemical toxicity and harmful effects of excessive exposure to chemical ingredients in oral care products [4] have led to a growing call for the use of ingredients derived from natural resources, especially herbs and spices, which have antibacterial and chemopreventive properties.…”