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Chlorhexidine-based disinfectant can be the best in killing bone tumor cells after surgical procedure

Chlorhexidine-based disinfectant can be the best in killing bone tumor cells after surgical procedure

Chlorhexidine gluconate (CHG), a extensively used disinfectant, seems to be the best irrigant within the surgical remedy of bone tumors, based on an experimental research carried out as a part of the WHO research on public well being. The web site Journal of Bone and Joint Surgical procedure. The newspaper is revealed in Lippincott’s portfolio in partnership with Wolters Kluwer.

Of the assorted options used to take away remaining tumor cells after surgical procedure, a 0.05% CHG answer seems to be the best in killing cultured bone tumor cells, based on the laboratory research by Matthew J. Thompson, MD, College of Washington, Seattle, and colleagues.

CHG displays the best cytotoxicity in opposition to chondrosarcoma and big cell tumors.

Some sufferers with bone tumors bear a surgical process referred to as intralesional curettage. On this process, the tumor is scraped away whereas preserving as a lot wholesome bone as potential. A typical adjuvant remedy is to irrigate the operative space of ​​the bone with some type of chemical answer. This irrigation is completed to cut back the variety of remaining cells which might probably result in tumor recurrence and re-bleeding.

A number of totally different options have been used for irrigation of the tumor mattress, together with saline, ethanol, and numerous disinfectants. Dr. Thompson and his colleagues carried out a sequence of experiments to find out which of those options has the best cytotoxic (cell killing) impact on bone tumor cells.

The experiments used cultures of two varieties of bone tumors: big cell tumor, a benign however aggressive tumor, and chondrosarcoma, a kind of bone most cancers. Tumor cell cultures have been handled with one in all six totally different options: sterile water, 0.9% saline, 70% ethanol, 3% hydrogen peroxide, 0.05% CHG, and povidone iodine at 0.3%. The cytotoxicity was in contrast for the totally different therapies.

Of the six therapies, solely CHG had cell killing effectivity equal to manage answer with 100% cytotoxicity, and this consequence was noticed whatever the remedy interval (i.e. 2 minutes or 5 minutes).

Not one of the different options approached the cell killing effectivity of CHG. Solely two options (sterile water and hydrogen peroxide) have been discovered to be superior to a low cytotoxicity management remedy. The opposite three options examined – saline, ethanol and povidone-iodine – confirmed little or no cytotoxicity.

Chlorhexidine is a well-known disinfectant with numerous medical makes use of, together with as a topical antiseptic agent earlier than surgical procedure. The researchers write: [CHG] is extensively used and available, with demonstrated in vivo security in different surgical functions and decrease predicted toxicity in comparison with some at present used brokers. »

The brand new research exhibits that CHG could be very efficient at killing bone tumor cells – at the very least underneath laboratory circumstances. “Due to this fact, scientific use of 0.05% CHG answer might function a possible chemical adjuvant throughout intralesional curettage of chondrosarcoma and [giant cell tumors]Thompson and his co-authors conclude.

The researchers level out that additional research can be wanted to evaluate the outcomes of CHG irrigation in sufferers present process surgical procedure. Dr. Thompson feedback: “We imagine you will need to proceed to discover higher methods to realize long-lasting native management of aggressive benign tumors corresponding to big cell tumor of bone, that are related to a excessive threat of native recurrence when handled with typical intensive intralesional curettage. »

Supply :

Journal reference:

DOI: 10.2106/JBJS.22.00404

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