TOXIC EFFECTS OF WOUND IRRIGATION SOLUTIONS ON CULTURED TIBIAE AND OSTEOBLASTS

Irrigating wounds with solutions of antiseptic or antibiotic agents is routinely performed in orthopaedic surgery to reduce the incidence of microbial infection. The effects of these agents on healthy bone tiss ue is unknown. Three commonly employed antiseptic agents (hydrogen per oxide, Betadine solution. Betadine scrub) and one antibiotic solution (bacitracin) were tested on tibiae and osteoblasts isolated from embry onic chicks. Osteoblast function was evaluated by glycolytic energy me tabolism (lactate production), cell number (DNA content), and collagen synthesis ([H-3]proline hydroxylation). Two series of experiments wer e performed. To study concentration-related effects, tibiae or cells w ere exposed to a range of concentrations of the agents (diluted in sal ine, 0.9% NaCl) for 2 min, rinsed with saline, and incubated for 24 h in medium containing [H-3]proline. For the recovery study, the cells w ere exposed to an effective, but nonlethal, concentration of the antis eptic agents for 2 min, rinsed with saline, and the incubation was con tinued in complete culture medium for 6, 12, 24, 48, or 72 h with [H-3 ]proline added for the final 6 h. Solutions containing the antiseptic agents were cytotoxic to both bones and cells at concentrations well b elow those used clinically in irrigation solutions. In contrast, bacit racin at the concentrations tested was safe for osteoblasts and tibiae . These results suggest that the use of irrigation solutions containin g H2O2, Betadine solution, or Betadine scrub on exposed bone tissue sh ould be considered with caution.