The Effects of Chlorhexidine Graft Decontamination on Tendon Graft Collagen and Cell Viability

Alomar, Abdulaziz Z.; Gawri, Rahul; Roughley, Peter J.; Haglund, Lisbet; Burman, Mark

doi:10.1177/0363546512443808

Cited by 14 publications

(17 citation statements)

References 36 publications

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“…It dissociates and releases the positively charged chlorhexidine cation. In turn, this cation binds to the negatively charged bacterial cell walls resulting in leakage of cellular contents, precipitation of intracellular compounds, and inhibition of adenosine triphosphate, which eventually inactivate or kill the bacteria [19,24]. In this study, complete inhibition of microbial contamination of sh skin was not achieved even with increasing the contact time till 15 min.…”

Section: Discussionmentioning

confidence: 59%

“…In consistent with previous data [11], our results showed that CHG at concentration 4% was effective in the reduction of microbial load of tilapia sh skin in variable degrees and the bactericidal effect increased with increasing contact time. CHG is a bisbiguanide compound that has a broad spectrum of activity against gram-positive and gram-negative bacteria and fungi, even in the presence of interfering materials, such as blood or serum [19,24]. It dissociates and releases the positively charged chlorhexidine cation.…”

Section: Discussionmentioning

confidence: 99%

“…Chlorhexidine and povidone iodine are routinely used for sterilization and disinfection of grafting procedures as they are effective against Gramnegative, Gram-positive bacteria and fungi and kills by disruption of the cell membrane [11,[19][20][21][22]. In addition, silver nanoparticles have long been known as an antimicrobial agent and are used as silver-containing wound dressings and for disinfection of the wound graft [13,23].…”

Section: Introductionmentioning

confidence: 99%

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Validation of three different sterilization methods of Tilapia skin dressing: impact on microbiological enumeration and collagen content

Ibrahim

Hassan

Kelany

et al. 2020

Preprint

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Background Tilapia fish skin has demonstrated promise as a stable and practical biological dressing to be used in wound and burn management. However, the appropriate sterilization technique of the Tilapia fish skin is crucial before its clinical application. The standard sterilization technique must eliminate harmful pathogens but maintain the structural and biochemical properties that could compromise the dressing function. This study investigated and compared the efficiency of three sterilizing agents; chlorhexidine gluconate 4% (CHG), povidone iodine 10% (PVP-I), and silver nanoparticles (25 µg/mL) (AgNPs), at three different times (5, 10, and 15 min) on Tilapia fish skin based on the microbial count, histological and collagen properties. Results Among the sterilization procedures, AgNPs showed rapid and complete antimicrobial activity, with a 100% reduction in microbial growth of the fish skin throughout the treated times. Furthermore, AgNPs did not impair the cellular structure or collagen fibers content of the fish skin. However, CHG and PVP-I caused alterations in the collagen content. Conclusion This study demonstrated that the AgNPs treatment of Tilapia fish skin provided sterile skin while preserving the histological properties and structural integrity. These findings provide an efficient and quick sterilization method suitable for Tilapia fish skin that could be adopted as a biological dressing.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validation of three different sterilization methods of Tilapia skin dressing: impact on microbiological enumeration and collagen content

Ibrahim

Hassan

Kelany

et al. 2020

Preprint

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“…The effect on wound healing is controversial. 22 A decontamination protocol with 3 L of 2% chlorhexidine irrigation has been published. The study showed no change in maximal graft load for failure, final stress failure or stiffness.…”

Section: Discussionmentioning

confidence: 99%

Descontaminação transoperatória de enxerto durante cirurgia de reconstrução do LCA

Luciano¹,

Macedo²,

Pereira³

et al. 2020

Rev Bras Ortop (Sao Paulo)

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Objective To evaluate different decontaminants for tendon grafts, proposing an antiseptic protocol for contaminated grafts. Methods A total of 25 patients were tissue donors for the study. Each participant donated a 2.5-cm tendon sample, which was divided into 5 fragments with 5 mm each during anterior cruciate ligament (ACL) reconstruction surgery. The collected material was divided into 5 groups, totaling 125 samples. In total, four fragments of each patient were placed on the operating room floor for one minute for contamination, simulating the fall of the graft on the floor during surgery. The other fragment was immediately placed in a sterile container (group 1). One of the contaminated fragments was placed in the sterile container without being previously immersed in decontaminating solution (group 2). The remaining fragments were immersed for ten minutes in decontaminating solution: 0.5% chlorhexidine (group 3), 0.9% saline (group 4) and 0.55% ortho-phthalaldehyde (group 5), and, after this time, they were individually placed in a sterile container. The samples from the 5 groups were submitted to microbiological examination. Results Bacteria were detected in 26% of the total samples in the microbiological tests, and in group 1 there was no growth of microorganisms. In group 2, bacterial growth was observed in 16 samples. Considering the evaluation of test groups 3, 4 and 5, the percentage of decontamination was higher than the growth of microorganisms in the respective cultures. Conclusion The protocol suggested by the study showed that intraoperative graft decontamination is possible.

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“…Con respecto al efecto que la clorhexidina ejerce sobre las propiedades bioquímicas del colágeno y fibroblastos, Alomar y col., 14 reportó que el lavado a presión pulsátil con clorhexidina al 4%, disocia el colágeno recién formado, mientras que el uso de clorhexidina al 2%, no afecta su integridad . Con respecto a la viabilidad celular, sus resultados resaltan que el lavado pulsátil a concentraciones tan bajas como el 2%, tiene efectos citotóxicos en los fibroblastos, lo cual provocaría que el injerto se comportase como un aloinjerto, necesitando más tiempo para su intengración y confiréndole un mayor riesgo de falla.…”

Section: Discussionunclassified

Encuesta sobre el manejo de injertos del ligamento cruzado anterior contaminados accidentalmente

Figueroa

Calvo

et al. 2019

Rev Chil Ortop Traumatol

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Resumen Objetivo Encuestar a cirujanos de rodilla en Chile, sobre su conducta en contaminaciones accidentales del injerto, en reconstrucciones de ligamento cruzado anterior (LCA). Métodos Se realizó una encuesta anónima en relación a la incidencia, tratamiento y resultados clínicos de los injertos de LCA contaminados, a todos los médicos pertenecientes al área de traumatología y ortopedia asistentes al congreso Ateneo de rodilla 2015. Resultados Se encuestaron 54 médicos, 33 (61%) especialistas en cirugía de rodilla y 21 (39%) médicos en formación. De los cirujanos de rodilla, 15 (45%) reportaron al menos un caso de contaminación, de los cuales 12 (80%) informaron un único evento, 3 (20%) indicaron la eventualidad en 2, 3 y 5 ocasiones respectivamente, para un total de 22 injertos contaminados. De los cirujanos que reportaron injertos contaminados, 11 (73%) realizan 50 o más reconstrucciones al año. La decisión tomada en los casos de contaminación fue en 13 oportunidades (59%), lavar el injerto y utilizarlo de acuerdo al plan inicial; en 6 casos (27%), utilizar aloinjerto; en 2 ocasiones (9%), utilizar autoinjerto alternativo; y en 1 oportunidad (5%); triplicar el semitendinoso. Ninguno de los casos de contaminación reportó infecciones. Conclusiones En casos de una contaminación accidental, la mayoría de los cirujanos encuestados prefieren optar por la descontaminación del injerto y su utilización en la reconstrucción de acuerdo al plan inicial; para lo cual la clorhexidina y antibióticos sería la solución a usar de preferencia. Nivel de Evidencia Nivel V, opinión de experto.

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The Effects of Chlorhexidine Graft Decontamination on Tendon Graft Collagen and Cell Viability

Cited by 14 publications

References 36 publications

Validation of three different sterilization methods of Tilapia skin dressing: impact on microbiological enumeration and collagen content

Validation of three different sterilization methods of Tilapia skin dressing: impact on microbiological enumeration and collagen content

Descontaminação transoperatória de enxerto durante cirurgia de reconstrução do LCA

Encuesta sobre el manejo de injertos del ligamento cruzado anterior contaminados accidentalmente

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