Disinfecting agents for removing adherent bacteria from orthopaedic hardware

Area of Science:

• Orthopaedic surgery
• Biomaterials science
• Infectious disease

Background:

• Orthopaedic implant infections pose significant challenges.
• Effective disinfection of implanted hardware is crucial for patient outcomes.
• Surfactants and detergents are potential agents for wound irrigation.

Purpose of the Study:

• To evaluate biocompatible surfactants and detergents for disinfecting orthopaedic wounds with implanted hardware.
• To identify an optimal irrigation agent for orthopaedic wound disinfection.
• To assess the efficacy of benzalkonium chloride against common orthopaedic pathogens.

Main Methods:

• Bacterial adhesion assays were performed.
• Irrigation studies evaluated disinfection efficacy.
• Bactericidal assays tested benzalkonium chloride against Staphylococcus epidermidis, Staphylococcus aureus, and Pseudomonas aeruginosa biofilms on stainless steel screws.
• Static and jet irrigation conditions were assessed.

Main Results:

• Benzalkonium chloride demonstrated the greatest efficacy among tested agents.
• Static immersion in benzalkonium chloride achieved a minimum 4 log kill against all three bacterial strains within 10 minutes.
• Jet irrigation enhanced disinfection, achieving a minimum 2 log kill at concentrations of 1:1000 and 1:5000.

Conclusions:

• Benzalkonium chloride exhibits significant in vitro disinfection properties for orthopaedic devices at tissue-compatible concentrations.
• The mechanical action of jet lavage can potentiate the antimicrobial efficacy of benzalkonium chloride.
• Benzalkonium chloride is a promising agent for disinfecting orthopaedic wounds with implanted hardware.