Human osteoblast damage after antiseptic treatment.
OBJECTIVE
Antiseptics are powerful medical agents used for wound treatment and decontamination and have a high potential for defeating joint infections in septic surgery. Both chlorhexidine and polyhexanide are frequently used in clinical practice and have a broad antimicrobial range, but their effect on human osteoblasts has not been sufficiently studied. Our objective was to investigate the toxic effects of polyhexanide and chlorhexidine on human osteoblasts in vitro to evaluate their clinical applicability in septic surgery.


METHODS
We isolated and cultivated human osteoblasts in vitro and assayed the toxic effects of chlorhexidine 0.1% and polyhexanide 0.04%, concentrations commonly applied in clinical practice. Toxicity analysis was performed by visualisation of cell structure, lactate dehydrogenase (LDH) activity and evaluation of vital cells. Toxicity was evaluated by microscopic inspection of cell morphology, trypan blue staining and determination of LDH release.


RESULTS
Damaged cell structure could be shown by microscopy. Both antiseptics promoted LDH activity after incubation with osteoblasts. The evaluation of vital osteoblasts showed a significant decrease of vital cells.


CONCLUSIONS
Both antiseptics induced significant cell death of osteoblasts at optimum exposure. We therefore recommend cautious use of polyhexanide and chlorhexidine in septic surgery to avoid severe osteoblast toxicity.
Pauline
P
Vörös
Oliver
O
Dobrindt
Carsten
C
Perka
Christoph
C
Windisch
Georg
G
Matziolis
Eric
E
Röhner
D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D001645:Biguanides / Q000494:pharmacology; D002470:Cell Survival / Q000187:drug effects; D002478:Cells, Cultured; D002710:Chlorhexidine / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D066298:In Vitro Techniques; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D010006:Osteoblasts / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology*
D000891:Anti-Infective Agents, Local; D001645:Biguanides; C031233:polihexanide; D007770:L-Lactate Dehydrogenase; D002710:Chlorhexidine