浸泡在聚维酮碘、氯己定、替柯planin、万古霉素和生理盐水溶液中会对猪屈肌腱大小和生物力学性能产生不同的影响

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-08-01 DOI:10.1016/j.asmr.2025.101168

Kaan Gurbuz M.D. , Yukun Zhang Ph.D. , Logan Opperman Ph.D. , Matthew B. Fisher Ph.D.

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引用次数: 0

摘要

目的比较聚维酮碘、氯己定、万古霉素和替柯planin对猪屈肌腱移植物大小和生物力学性能的影响。方法收集孢素类指屈深肌腱120根，每对分为聚维酮碘组、氯己定组、万古霉素组、替柯planin组和生理盐水组，每组12对。一侧肌腱在这些溶液中浸泡30分钟，而另一侧肌腱则用盐水浸泡的纱布包裹。在浸泡前后测量肌腱横截面积（CSA），以及未浸泡的对照组。进行拉伸试验直至失效。计算了刚度、失效载荷、模量和失效应力。结果聚维酮碘浸泡和氯己定浸泡分别使CSA平均值降低8% （-0.9 mm2[95%可信区间（CI）， -1.7 ~ -0.2 mm2], P = 0.02）和13% （-1.1 mm2 [95% CI, -1.5 ~ -0.7 mm2], P < 001）。相反，浸泡在替柯planin （1.0 mm2 [95% CI, 0.7 ~ 1.3 mm2], P < 0.001）后平均CSA增加12%，浸泡在万古霉素（0.7 mm2 [95% CI, 0.2 ~ 1.2 mm2], P = 0.01）后平均CSA增加6%，与盐水溶液相似（增加11%，0.8 mm2 [95% CI, 0.4 ~ 1.1 mm2], P < 0.001）。与未浸泡的对侧对照相比，浸泡氯己定后的肌腱刚度降低了8% (-13.3 N/mm [95% CI, -31.0 ~ -6.9 N/mm], P = 0.01)，但破坏时的应力增加了15% （8.9 MPa [95% CI, 0.6 ~ 17.2 MPa], P = 0.04）。我们观察到浸泡在其他溶液中的拉伸性能没有显著差异。结论聚维酮碘和氯己定浸泡猪屈肌腱使CSA降低，万古霉素和替可普宁浸泡猪屈肌腱使CSA升高，与生理盐水相似。平均CSA没有显著的侧对侧差异。浸泡在氯己定中降低了刚度，但增加了失效时的应力。所有解决方案都不会影响故障时的负载。重要的是要了解浸泡猪屈肌腱移植物在各种抗菌溶液中的影响，以确保在临床环境中使用的组织没有有害的生物力学效应。

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Soaking in Povidone-Iodine, Chlorhexidine, Teicoplanin, Vancomycin, and Saline Solution Differentially Alters Porcine Flexor Tendon Size and Biomechanical Properties

Purpose

To compare the impact of povidone-iodine, chlorhexidine, vancomycin, and teicoplanin on the size and biomechanical properties of porcine flexor tendon grafts.

Methods

Porcine deep digital flexor tendons (N = 120) were collected in pairs and allocated into povidone-iodine, chlorhexidine, vancomycin, teicoplanin, and saline solution groups (12 pairs per solution). The tendons from one side underwent a 30-minute soaking in these solutions, whereas those from the other side were wrapped in saline solution–soaked gauze. Tendon cross-sectional area (CSA) was measured before and after soaking, along with unsoaked controls. Tensile testing to failure was performed. Stiffness, load at failure, modulus, and stress at failure were calculated.

Results

Soaking in povidone-iodine and chlorhexidine decreased the average CSA by 8% (–0.9 mm² [95% confidence interval (CI), –1.7 to –0.2 mm²], P = .02) and 13% (–1.1 mm² [95% CI, –1.5 to –0.7 mm²], P < .001), respectively. Conversely, the average CSA increased by 12% after soaking in teicoplanin (1.0 mm² [95% CI, 0.7 to 1.3 mm²], P < .001) and by 6% after soaking in vancomycin (0.7 mm² [95% CI, 0.2 to 1.2 mm²], P = .01), similar to saline solution (11% increase; 0.8 mm² [95% CI, 0.4 to 1.1 mm²], P < .001). The stiffness of tendons soaked in chlorhexidine was 8% lower than that of unsoaked contralateral controls (–13.3 N/mm [95% CI, –31.0 to –6.9 N/mm], P = .01), but stress at failure increased by 15% (8.9 MPa [95% CI, 0.6 to 17.2 MPa], P = .04). We observed no significant difference in tensile properties due to soaking in other solutions.

Conclusions

Soaking porcine flexor tendons in povidone-iodine and chlorhexidine resulted in a decrease in CSA, whereas soaking in vancomycin and teicoplanin led to an increase, similar to saline solution. No significant side-to-side differences in average CSA were observed. Soaking in chlorhexidine decreased stiffness but increased stress at failure. None of the solutions affected load at failure.

Clinical Relevance

It is important to understand the impact of soaking porcine flexor tendon grafts in various antimicrobial solutions to ensure that there are no harmful biomechanical effects to the tissues used in the clinical setting.

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