Fw. Moussa et al., DISINFECTING AGENTS FOR REMOVING ADHERENT BACTERIA FROM ORTHOPEDIC HARDWARE, Clinical orthopaedics and related research, (329), 1996, pp. 255-262
This investigation seeks to determine whether surfactants or detergent
s can be used to clean and disinfect orthopaedic wounds with implanted
hardware. Thus, a stepwise investigation of biocompatible surfactants
and detergents was performed to identify an irrigation agent for disi
nfecting orthopaedic wounds, Bacterial adhesions assays, irrigation st
udies, and bactericidal assays determined that benzalkonium chloride s
howed the greatest efficacy, Testing involved stainless steel screws c
olonized with a preformed biofilm of Staphylococcus epidermidis, Staph
ylococcus aureus, or Pseudomonas aeruginosa, which were immersed in be
nzalkonium chloride solutions for various time intervals under static
conditions, After 10 minutes, benzalkonium chloride achieved a minimum
4 log kill (10,000-fold) for all 3 strains of bacteria, Additional st
udies demonstrated that the high mechanical energy of jet irrigation i
mproved the disinfecting properties of this agent, With jet lavage, bo
th 1:1000 and 1:5000 concentrations of benzalkonium chloride achieved
a minimum 2 log kill (100-fold) for all 3 bacteria, The results of thi
s study suggest that at tissue compatible concentrations, benzalkonium
chloride has significant disinfection properties for in vitro coloniz
ed orthopaedic devices, and these properties may be enhanced via jet l
avage.