title: Benzalkonium chloride: a potential disinfecting irrigation solution.
abstract: OBJECTIVE
  To determine the disinfecting properties of benzalkonium chloride as an irrigation agent.
  
  
  METHODS
  Comparison was made between irrigation of contaminated muscle strips with benzalkonium chloride and normal saline (control).
  
  
  BACKGROUND
  Benzalkonium chloride is a cationic disinfectant, which has questionable efficacy in an organic environment. However, no previous study has attempted to use high volumes of this cationic solution to overcome the neutralizing effect of organic tissue and thus maintain this detergent's germicidal properties.
  
  
  METHODS
  2.5 cm x 0.5 cm x 0.5 cm pieces of bovine muscle were aseptically cut from the center of freshly harvested beef muscle and incubated with 1.0 x 10(7) colony forming units of bacteria for 15 minutes. The muscle strips were then irrigated with either 100 mL, 1 L, or 10 L of benzalkonium chloride at a 1:2000 concentration in normal saline. Normal saline was used as the control. The muscle strips were sonicated to remove adherent bacteria; the number of living organisms was determined by quantitatively culturing the sonicate.
  
  
  RESULTS
  In vitro, benzalkonium chloride was superior to normal saline at disinfecting bovine muscle (p < or = 0.001). When 10 L of benzalkonium chloride irrigation was used, no living bacteria could be recovered (p < or = 0.012).
  
  
  CONCLUSIONS
  In this experimental setting benzalkonium chloride was an effective disinfection agent, with enhanced activity at large volumes.
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri Hospital and Clinics, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Gainor
authors.forename: D E
authors.initials: DE
authors.lastname: Hockman
authors.forename: J O
authors.initials: JO
authors.lastname: Anglen
authors.forename: G
authors.initials: G
authors.lastname: Christensen
authors.forename: W A
authors.initials: WA
authors.lastname: Simpson
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000494:pharmacology*; D001548:Benzalkonium Compounds / Q000008:administration & dosage / Q000494:pharmacology*; D002417:Cattle; D015169:Colony Count, Microbial; D003470:Culture Media; D046508:Culture Techniques; D018482:Muscle, Skeletal / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000254:growth & development; D012965:Sodium Chloride / Q000494:pharmacology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000254:growth & development; D013234:Stem Cells / Q000187:drug effects; D007507:Therapeutic Irrigation / Q000379:methods*
chemical_list: D000891:Anti-Infective Agents, Local; D001548:Benzalkonium Compounds; D003470:Culture Media; D012965:Sodium Chloride