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| 次氯酸冲洗的体外安全性及有效性评估 |
| 张浩,庄新晨,盛世豪,张涛,崔进,周启荣,潘思华,陈晓,苏佳灿* |
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(海军军医大学(第二军医大学)第一附属医院创伤骨科, 上海 200433
*通信作者) |
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| 摘要: |
| 目的 通过体外实验评估低浓度次氯酸（HClO）冲洗清创用于开放性骨折感染的安全性及抗菌有效性。方法 取小鼠上皮样成纤维细胞系L929细胞和成骨细胞系MC3T3-E1细胞，分别设置空白对照组及不同浓度（10%、30%、50%和100%）HClO组，通过体外细胞集落形成实验、细胞增殖实验及细胞凋亡实验评估不同浓度HClO的安全性；取小鼠红细胞，设置生理盐水组、PBS组和不同浓度（10%、30%、50%和100%）HClO组，通过溶血实验评估不同浓度HClO的溶血风险；培养金黄色葡萄球菌和大肠埃希菌，分别设置空白对照组、10% HClO组和抗生素阳性对照组进行细菌生长抑制实验，分别设置空白对照组、10% HClO组、抗生素阳性对照组、碘伏组和过氧化氢组进行抑菌圈实验，评估低浓度HClO的抗菌效果。结果 体外实验表明10% HClO组小鼠L929和MC3T3-E1细胞有明显的集落形成，细胞增殖抑制率和凋亡率均较低；而30%、50%和100% HClO组小鼠L929和MC3T3-E1细胞无集落形成，细胞增殖抑制率和凋亡率均高于10% HClO组（P均<0.01）。各浓度HClO组小鼠红细胞溶血实验均呈阴性。10% HClO可显著抑制细菌生长，具有与碘伏及过氧化氢相似的抑菌效果。结论 低浓度（10%）HClO安全性高，对革兰氏阳性菌和革兰氏阴性菌均有较好的抑制效果，是临床治疗开放性骨折、骨髓炎及感染性骨缺损的潜在清创冲洗剂。 |
| 关键词: 次氯酸 开放性骨折 骨髓炎 感染 清创术 |
| DOI：10.16781/j.CN31-2187/R.20220068 |
| 投稿时间：2022-01-17修订日期：2022-02-05 |
| 基金项目:国家重点研发计划重点专项（2018YFC2001500），国家自然科学基金（82172098）. |
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| In vitro safety and efficacy assessment of hypochlorous acid irrigation |
| ZHANG Hao,ZHUANG Xin-chen,SHENG Shi-hao,ZHANG Tao,CUI Jin,ZHOU Qi-rong,PAN Si-hua,CHEN Xiao,SU Jia-can* |
(Department of Traumatic Orthopaedics, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To evaluate the safety and antimicrobial efficacy of low concentration hypochlorous acid (HClO) irrigation for the prevention of open fracture infection in vitro. Methods Mouse epithelioid fibroblast cell line L929 and osteoblast MC3T3-E1 cells were used in this study, and blank control group and HClO groups with different concentrations (10%, 30%, 50% and 100%) were set up. The safety of different concentrations of HClO was evaluated by cell colony formation test, cell proliferation test and apoptosis test in vitro. The red blood cells of mice were taken, and normal saline group, phosphate buffered saline (PBS) group and HClO groups with different concentrations (10%, 30%, 50% and 100%) were set up. The hemolysis risk of different concentrations of HClO was evaluated by hemolysis test. To evaluate the antibacterial effect of low concentration HClO, Staphylococcus aureus and Escherichia coli were cultured in the blank control group, 10% HClO group and antibiotic positive control group to observe the growth of bacteria; and the blank control group, 10% HClO group, antibiotic positive control group, iodophor group and hydrogen peroxide group were set up for the bacteriostatic circle experiment. Results In vitro experiments showed that L929 and MC3T3-E1 cells had colony formation and lower proliferation inhibition and apoptosis rates in the 10% HClO group, while they had no colony formation but higher proliferation inhibition and apoptosis rates in the 30%, 50% and 100% HClO groups (all P<0.01). The erythrocyte hemolysis test was negative at all concentrations in HClO group. Low concentration (10%) HClO could significantly inhibit bacterial growth and had the same antibacterial effect as iodophor and hydrogen peroxide. Conclusion Low concentration (10%) HClO is safe and has good inhibitory effect on both Gram-positive and Gram-negative bacteria. It is a potential irrigation for clinical treatment of open fractures, osteomyelitis and infected bone defects. |
| Key words: hypochlorous acid open fractures osteomyelitis infection debridement |
