Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblasts

<p class="p p-first" id="__p2"><strong>Introduction:</strong> Chlorhexidine gluconate (CHX) is widely used as a preoperative surgical skin-preparation solution and intra-wound irrigation agent, with excellent efficacy against wide variety of bacteria. The cytoto...

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Main Authors: J. X. Liu, J. Werner, T. Kirsch, J. D. Zuckerman, M. S. Virk
Format: Article
Language:English
Published: Copernicus Publications 2018-08-01
Series:Journal of Bone and Joint Infection
Online Access:https://jbji.copernicus.org/articles/3/165/2018/jbji-3-165-2018.pdf
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author J. X. Liu
J. Werner
T. Kirsch
J. D. Zuckerman
M. S. Virk
author_facet J. X. Liu
J. Werner
T. Kirsch
J. D. Zuckerman
M. S. Virk
author_sort J. X. Liu
collection DOAJ
description <p class="p p-first" id="__p2"><strong>Introduction:</strong> Chlorhexidine gluconate (CHX) is widely used as a preoperative surgical skin-preparation solution and intra-wound irrigation agent, with excellent efficacy against wide variety of bacteria. The cytotoxic effect of CHX on local proliferating cells following orthopaedic procedures is largely undescribed. Our aim was to investigate the <em>in vitro</em> effects of CHX on primary fibroblasts, myoblasts, and osteoblasts.</p><p id="__p3"><strong>Methods:</strong> Cells were exposed to CHX dilutions (0%, 0.002%, 0.02%, 0.2%, and 2%) for either a 1, 2, or 3-minute duration. Cell survival was measured using a cytotoxicity assay (Cell Counting Kit-8). Cell migration was measured using a scratch assay: a “scratch” was made in a cell monolayer following CHX exposure, and time to closure of the scratch was measured.</p><p id="__p4"><strong>Results:</strong> All cells exposed to CHX dilutions of ≥ 0.02% for any exposure duration had cell survival rates of less than 6% relative to untreated controls (p &lt; 0.001). Cells exposed to CHX dilution of 0.002% all had significantly lower survival rates relative to control (p &lt; 0.01) with the exception of 1-minute exposure to fibroblasts, which showed 96.4% cell survival (p = 0.78). Scratch defect closure was seen in &lt; 24 hours in all control conditions. However, cells exposed to CHX dilutions ≥ 0.02% had scratch defects that remained open indefinitely.</p><p class="p p-last" id="__p5"><strong>Conclusions:</strong> The clinically used concentration of CHX (2%) permanently halts cell migration and significantly reduces survival of <em>in vitro</em> fibroblasts, myoblasts, and osteoblasts. Further <em>in vivo</em> studies are required to examine and optimize CHX safety and efficacy when applied near open incisions or intra-wound application.</p>
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spelling doaj.art-6df8e6b1177f45d58928cf4bd277160e2022-12-21T22:27:07ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522018-08-01316517210.7150/jbji.26355Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblastsJ. X. Liu0J. Werner1T. Kirsch2J. D. Zuckerman3M. S. Virk4NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003NYU Langone Medical Center, Hospital for Joint Diseases, 301 E. 17th St., New York, NY 10003<p class="p p-first" id="__p2"><strong>Introduction:</strong> Chlorhexidine gluconate (CHX) is widely used as a preoperative surgical skin-preparation solution and intra-wound irrigation agent, with excellent efficacy against wide variety of bacteria. The cytotoxic effect of CHX on local proliferating cells following orthopaedic procedures is largely undescribed. Our aim was to investigate the <em>in vitro</em> effects of CHX on primary fibroblasts, myoblasts, and osteoblasts.</p><p id="__p3"><strong>Methods:</strong> Cells were exposed to CHX dilutions (0%, 0.002%, 0.02%, 0.2%, and 2%) for either a 1, 2, or 3-minute duration. Cell survival was measured using a cytotoxicity assay (Cell Counting Kit-8). Cell migration was measured using a scratch assay: a “scratch” was made in a cell monolayer following CHX exposure, and time to closure of the scratch was measured.</p><p id="__p4"><strong>Results:</strong> All cells exposed to CHX dilutions of ≥ 0.02% for any exposure duration had cell survival rates of less than 6% relative to untreated controls (p &lt; 0.001). Cells exposed to CHX dilution of 0.002% all had significantly lower survival rates relative to control (p &lt; 0.01) with the exception of 1-minute exposure to fibroblasts, which showed 96.4% cell survival (p = 0.78). Scratch defect closure was seen in &lt; 24 hours in all control conditions. However, cells exposed to CHX dilutions ≥ 0.02% had scratch defects that remained open indefinitely.</p><p class="p p-last" id="__p5"><strong>Conclusions:</strong> The clinically used concentration of CHX (2%) permanently halts cell migration and significantly reduces survival of <em>in vitro</em> fibroblasts, myoblasts, and osteoblasts. Further <em>in vivo</em> studies are required to examine and optimize CHX safety and efficacy when applied near open incisions or intra-wound application.</p>https://jbji.copernicus.org/articles/3/165/2018/jbji-3-165-2018.pdf
spellingShingle J. X. Liu
J. Werner
T. Kirsch
J. D. Zuckerman
M. S. Virk
Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblasts
Journal of Bone and Joint Infection
title Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblasts
title_full Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblasts
title_fullStr Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblasts
title_full_unstemmed Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblasts
title_short Cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts, myoblasts, and osteoblasts
title_sort cytotoxicity evaluation of chlorhexidine gluconate on human fibroblasts myoblasts and osteoblasts
url https://jbji.copernicus.org/articles/3/165/2018/jbji-3-165-2018.pdf
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AT tkirsch cytotoxicityevaluationofchlorhexidinegluconateonhumanfibroblastsmyoblastsandosteoblasts
AT jdzuckerman cytotoxicityevaluationofchlorhexidinegluconateonhumanfibroblastsmyoblastsandosteoblasts
AT msvirk cytotoxicityevaluationofchlorhexidinegluconateonhumanfibroblastsmyoblastsandosteoblasts