Human osteoblast damage after antiseptic treatment

Abstract

Purpose Antiseptics are powerful medical agents 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. Our objective was to investigate the toxic effects of polyhexanide and chlorhexidine on human osteoblasts in vitro to evaluate 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 analysis was performed by visualisation of cell structure, lactate dehydrogenase (LDH) activity and evaluation of vital cells. Toxicity was evaluated by microscopic inspection of cell morphology, trypan blue staining 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 optimum exposure. We therefore recommend cautious use of polyhexanide and chlorhexidine in septic surgery to avoid severe osteoblast toxicity.

Melatonin in the oral cavity: physiological and pathological implications

“…CHX has also been proposed as a potentially effective agent to support periodontal bone regeneration . As with many drugs, the destructive actions of CHX on normal tissues, including osteoblasts, is related to excessive free radical generation . Given that melatonin, due to its free radical scavenging activities and antioxidative actions , has been repeatedly shown to reduce the destructive side effects of many agents, it is predicted that melatonin would also limit the toxicity of CHX thereby making it a more effective agent for use in preserving oral health.…”

Antibacterial Activity and Impact of Different Antiseptics on Biofilm-Contaminated Implant Surfaces

“…Similar results were also observed for the 37% OPA and 1% CHX gel formulations, further supporting the possible use of antiseptic gels for the treatment of infected implant surfaces, since gel formulations may limit the accidental contact of the antiseptic agent to the surrounding tissues. CHX has however also been shown to possess cytotoxic effect against host tissues [27][28][29][30], whereas OPA's cytotoxic properties have been highlighted by a single study and, hence, warrants further investigation [31].…”

The Effect of Antiseptics in the Prophylaxis of Infection in Orthopaedic Surgery

“…Conversely, PHMB requires 5-20 min for optimal antiseptic actions. However, a concentration as low as 0.02 % has been reported to be effective even against biofilm formation [37,38]. In addition, PHMB is considered to be the least toxic antiseptic among all agents, except taurolidine [39].…”