Pulse-Lavage Brushing Followed by Hydrogen Peroxide-Gauze Packing for Bone-Bed Preparation in Cemented Total Hip Arthroplasty: A Bovine Model

Ackland, David C.; Yap, Vincent; Ackland, M. Leigh; Williams, Jenny; Steiger, Richard de

doi:10.1177/230949900901700310

Cited by 12 publications

(18 citation statements)

References 23 publications

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“…In addition, the killing ability of H 2 O 2 on pathogenic bacteria like Pseudomonas aeruginosa is doubtful because catalases are reported to exist in their bodies [55] . H 2 O 2 is also used regularly to prepare the bony bed in cemented arthroplasties as well as to achieve hemostasis in neurosurgery [56,57] . It is also an adjunct hemostatic to topical epinephrine in patients with known platelet dysfunction after burn excision [58] .…”

Section: Current Clinical Use Of Hydrogen Peroxidementioning

confidence: 99%

Hydrogen Peroxide: A Potential Wound Therapeutic Target

Zhu¹,

Wang²,

Lu³

et al. 2017

Med Princ Pract

109

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Hydrogen peroxide (H2O2) is a topical antiseptic used in wound cleaning which kills pathogens through oxidation burst and local oxygen production. H2O2 has been reported to be a reactive biochemical molecule synthesized by various cells that influences biological behavior through multiple mechanisms: alterations of membrane potential, generation of new molecules, and changing intracellular redox balance, which results in activation or inactivation of different signaling transduction pathways. Contrary to the traditional viewpoint that H2O2 probably impairs tissue through its high oxidative property, a proper level of H2O2 is considered an important requirement for normal wound healing. Although the present clinical use of H2O2 is still limited to the elimination of microbial contamination and sometimes hemostasis, better understanding towards the sterilization ability and cell behavior regulatory function of H2O2 within wounds will enhance the potential to exogenously augment and manipulate healing.

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Section: Current Clinical Use Of Hydrogen Peroxidementioning

confidence: 99%

Hydrogen Peroxide: A Potential Wound Therapeutic Target

Zhu¹,

Wang²,

Lu³

et al. 2017

Med Princ Pract

109

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“…They found no reduction in blood loss following hydrogen peroxide application compared to controls 34. Another study on hydrogen peroxide hemostatic effects in an animal model also demonstrated no benefit versus conventional hemostatic techniques 35.…”

Section: Basic Sciencementioning

confidence: 97%

Hydrogen Peroxide Wound Irrigation in Orthopaedic Surgery

Lü

Hansen

2017

J. Bone Joint Infect.

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As the burden of deep hardware infections continues to rise in orthopaedics, there is increasing interest in strategies for more effective debridement of colonized tissues and biofilm. Hydrogen peroxide has been used medically for almost a century, but its applications in orthopaedic surgery have yet to be fully determined. The basic science and clinical research on the antiseptic efficacy of hydrogen peroxide have demonstrated its efficacy against bacteria, and it has demonstrated potential synergy with other irrigation solutions such as chlorhexidine and povidone-iodine. While hydrogen peroxide is effective in infection reduction, there are concerns with wound healing, cytotoxicity, and embolic phenomena, and we recommend against hydrogen peroxide usage in the treatment of partial knee replacements, hemiarthroplasties, or native joints. Additionally, due to the potential for oxygen gas formation, hydrogen peroxide should not be used in cases of dural compromise, when pressurizing medullary canals, or when irrigating smaller closed spaces to avoid the possibility of air embolism. Finally, we present our protocol for irrigation and debridement and exchange of modular components in total joint arthroplasty, incorporating hydrogen peroxide in combination with povidone-iodine and chlorhexidine.

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“…It is thought that its ability to mechanically remove debris (fats, marrow and blood clots) and haemostasis allows cement to interdigitate deeper and thus better quality of cementation. 8 Ackland conducted a study comparing the quality of cementation using different methods of femoral canal preparation; he used pulsatile lavage followed by H 2 O 2 gauze packing, pulsatile lavage with saline, H 2 O 2 gauze packing alone or saline irrigation alone. He was able to show that pulsatile lavage alone regardless of whether it was with or without H 2 O 2 had the most significant effect on the quality of cementation.…”

Section: Bone Cementationmentioning

confidence: 99%

A rare and uncommon complication after use of hydrogen peroxide (H₂O₂): A review of use of H₂O₂ in orthopaedics

Chan

Tse

Wan

et al. 2020

Journal of Orthopaedics, Trauma and Rehabilitation

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Hydrogen peroxide (H2O2) is a commonly used chemical agent in orthopaedic practice for antisepsis, haemostasis and preparation of bone bed for cementation. However, the associated risks of H2O2 usage are not widely known. We report a case of suspected air embolism after use of H2O2 during drainage of a septic arthritis of the shoulder. Upon our literature review, we were able to demonstrate H2O2 to be beneficial in antisepsis and care of chronic wounds. However, it has not been proven to be superior to other antiseptics commonly used in orthopaedic surgery. Regarding its use in cementation, there is evidence to show it is more effective than saline however, the use of pulsatile lavage appears to be the most important factor affecting the quality of cementation. H2O2 has not been shown to be helpful with haemostasis. Prior to the use of H2O2, one should be cautious and understand its associated risks and precautions.

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Pulse-Lavage Brushing Followed by Hydrogen Peroxide-Gauze Packing for Bone-Bed Preparation in Cemented Total Hip Arthroplasty: A Bovine Model

Abstract: Pulse-lavage brushing is more effective at cleansing the femoral canal and increasing mechanical strength at the cement-bone interface than preparation with normal-saline irrigation or hydrogen peroxide-soaked gauze packing.

Cited by 12 publications

References 23 publications

Hydrogen Peroxide: A Potential Wound Therapeutic Target

Hydrogen Peroxide: A Potential Wound Therapeutic Target

Hydrogen Peroxide Wound Irrigation in Orthopaedic Surgery

A rare and uncommon complication after use of hydrogen peroxide (H₂O₂): A review of use of H₂O₂ in orthopaedics

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Pulse-Lavage Brushing Followed by Hydrogen Peroxide-Gauze Packing for Bone-Bed Preparation in Cemented Total Hip Arthroplasty: A Bovine Model

Abstract: Pulse-lavage brushing is more effective at cleansing the femoral canal and increasing mechanical strength at the cement-bone interface than preparation with normal-saline irrigation or hydrogen peroxide-soaked gauze packing.

Cited by 12 publications

References 23 publications

Hydrogen Peroxide: A Potential Wound Therapeutic Target

Hydrogen Peroxide: A Potential Wound Therapeutic Target

Hydrogen Peroxide Wound Irrigation in Orthopaedic Surgery

A rare and uncommon complication after use of hydrogen peroxide (H2O2): A review of use of H2O2 in orthopaedics

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Product

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A rare and uncommon complication after use of hydrogen peroxide (H₂O₂): A review of use of H₂O₂ in orthopaedics