Limited use of antiseptics in septic surgery

J Invest Surg. 2012 Oct;25(5):311-6. doi: 10.3109/08941939.2011.648718.

Abstract

In septic joint surgery, treatment with antiseptics is a standard procedure. Postinfectious degeneration of cartilage often results in early arthritis that necessitates joint replacement, even in young patients. It is still unclear whether antiseptics have only a toxic effect on chondrocytes or also induce late cell death through apoptosis. We hypothesized that commonly used antiseptics (polyhexanide, hydrogen peroxide, and chlorhexidine) induce different stages of apoptosis on human chondrocytes. Human chondrocytes were isolated and cultured. Polyhexanide, hydrogen peroxide, and chlorhexidine were added to the monolayer cultures. Early and late apoptotic cells were analyzed using flow cytometric detection of Annexin V, active caspases, and 7AAD, and fluorescence microscopy using Annexin V and propidium iodide staining. Flow cytometric analysis revealed an increase of Annexin V and active caspases expression of human chondrocytes after incubation with polyhexanide, hydrogen peroxide, and chlorhexidine. Fluorescence microscopy demonstrated a high number of apoptotic cells. Our data show that polyhexanide and chlorhexidine only promote the early stages of apoptosis without any differences in toxicity. Conversely, hydrogen peroxide induces early and later stages of apoptosis on primary human chondrocytes in vitro.

Publication types

  • Comparative Study

MeSH terms

  • Annexin A5 / metabolism
  • Anti-Infective Agents, Local / adverse effects*
  • Apoptosis / drug effects
  • Biguanides / adverse effects
  • Caspases / metabolism
  • Cells, Cultured
  • Chlorhexidine / adverse effects
  • Chondrocytes / drug effects*
  • Chondrocytes / metabolism
  • Chondrocytes / pathology*
  • Flow Cytometry
  • Humans
  • Hydrogen Peroxide / adverse effects
  • Joint Diseases / complications
  • Joint Diseases / drug therapy*
  • Joint Diseases / pathology
  • Microscopy, Fluorescence
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / methods
  • Propidium
  • Sepsis / complications
  • Sepsis / drug therapy*
  • Sepsis / pathology
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / pathology

Substances

  • Annexin A5
  • Anti-Infective Agents, Local
  • Biguanides
  • polihexanide
  • Propidium
  • Hydrogen Peroxide
  • Caspases
  • Chlorhexidine