Combined High Hydrostatic Pressure and Additive Chemical Treatment Enhances Decontamination Efficiency in Bone Tissue...

Area of Science:

• Biomedical Engineering
• Microbiology
• Orthopedic Surgery

Background:

• Osteomyelitis poses significant challenges in orthopedic surgery, often necessitating bone removal and creating critical defects.
• Autologous bone reimplantation requires effective sterilization to prevent reinfection.

Purpose of the Study:

• To investigate the efficacy of high hydrostatic pressure (HHP) combined with sodium dodecyl sulfate (SDS) and ethylenediaminetetraacetic acid (EDTA) for sterilizing bone.
• To evaluate this method against *Staphylococcus aureus* and *Staphylococcus epidermidis*, common osteomyelitis pathogens, in both planktonic and biofilm states.

Main Methods:

• Determined SDS/EDTA doses and exposed planktonic bacteria (*S. aureus*, *S. epidermidis*) to HHP (250-350 MPa) with additives.
• Quantified bacterial inactivation in biofilms on human bone cylinders using logarithmic reduction factors and scanning electron microscopy (SEM).

Main Results:

• *S. epidermidis* was inactivated at 350 MPa in saline, while *S. aureus* showed pressure tolerance.
• SDS/EDTA significantly enhanced HHP-induced killing of *S. aureus*, especially within biofilms.
• SEM confirmed membrane deformation and cell wall disruption.

Conclusions:

• HHP combined with SDS/EDTA is an effective physicochemical sterilization method for osteomyelitis pathogens in planktonic and biofilm forms.
• This approach shows potential for safe autologous bone reimplantation, improving clinical outcomes in orthopedic trauma surgery.