Comparative Study On The Bactericidal Effect Of Iodophor Irrigation And Soaking On Chronic Osteomyelitis In Rabbits

Objective:Chronic osteomyelitis is one of orthopedic diseases,its treatment has long been plagued by orthopedic surgeons,and with the increasingly widespread use of antibiotics,pathogen resistance rate is higher and higher,in order to reduce antibiotic resistance and observe the effect of iodophor sterilization,Through the artificial establishment of rabbit model of chronic osteomyelitis,remove the bone after the application of iodophor irrigation and immersion in two ways to sterilize the diseased bone,observe and compare the two ways of sterilization effect for the clinical treatment of chronic osteomyelitis to provide experimental basis and Theoretical basis.Methods:Forty healthy New Zealand white rabbits were randomly selected.The rabbits were fasted on the right side of the rabbits 1 day before experiment.The rats were anesthetized with 1% pentobarbital sodium 3ml / kg.,Anesthesia after the success of the experimental rabbit with supine position,the right upper tibia in the upper area of the use of electric shaving knife skin preparation faded hair,area of 5cm×3cm size,the surgeon hand washing hand,iodophor solution disinfection faded hair area 3 times,the conventional shop sterile towel single 6-10 layer,strictly follow the principle of aseptic operation to ensure that the surgical area aseptic,take the right side of the calf medial incision,about 3cm,followed by cutting the skin,layer by layer subcutaneous tissue,Postoperative operation carefully to avoid damage to soft tissue and nerve vessels,adequate hemostasis after surgery to clear,showing the right rabbit tibia in the upper section,the use of small type of periosteal stripper stripping part of the periosteum,fully reveal the tibial cortical bone,the use of diameter 5mm thickness drill bit drilling,penetrating the cortical bone,drilling the process of soft action,only penetrate the side of the cortical bone,into the medullary cavity,to avoid penetration of bilateral cortical bone and surrounding soft tissue injury,in the stripping of the tibial tibial Drill three holes with the same size,and then use a diameter of 1cm grinding drill,the three small holes into a size of about 1.5cm×1cm oval bone defect that bone window,the window after the use of small models,respectively,Bone window around the gently scraping part of the free cortical bone and a little cancellous bone,and then use the 2ml size of the syringe through the bone window to extract the medullary cavity bone marrow,after the completion of the use of 0.9% victory saline 5ml rinse the distal end of the pulp cavity,and the use of new syringes The rinse solution completely aspirated out of the medullary cavity;remove the configured 5x106 cfu Staphylococcus aureus suspension,shake after the use of burette draw 0.5ml Staphylococcus aureus by the bone window to the far and near the end of the cavity into the cavity,Minutes after the injection of Staphylococcus aureus liquid in the medullary cavity after the full diffusion,and then use the new burette to take the first configuration of the 5% paclitaxel sodium solution 0.5ml,the bone window to the far and near the tube cavity injection,A few minutes to be full of dilute salicylic acid sodium solution,to be aseptic bone wax closed bone window,0.9% saline full rinse the wound layer by layer after subcutaneous tissue and skin,sterile accessories dressing surgical incision,and then processed the white Rabbits were routinely fed for 4 weeksA total of 34 rabbits were selected to be diagnosed by chronic osteomyelitis by imaging examination,histopathological examination and general morphology observation.Fasting water was preoperatively held in these rabbits before surgery,The use of 1% pentobarbital sodium 3ml / kg,the ear vein anesthesia,anesthesia after the observation of experimental rabbits with better anesthesia,no experimental rabbits anesthesia death;anesthesia after the success of the experiment with rabbit supine,In the limb of the original surgical area using electric shaving knife skin preparation faded hair,the surgeon hand washing hand brush,iodine stock solution disinfection faded hair area 3 times,conventional shop sterile towel single 6-10 layer,strictly follow the aseptic operation Principle,take the patient's original longitudinal incision,followed by incision of the skin,layer by layer separation of subcutaneous tissue,careful operation after careful to avoid damage to soft tissue and nerve vessels,adequate hemostasis to make clear field,reveal the tibial bone Area of the larger area may be appropriate to extend the surgical incision),the use of small type of periosteal stripper along the bone area to the proximal and distal stripping part of the periosteum,showing no obvious abnormal bone tissue can be revealed,fully revealed,1cm of the eye can,t see the obvious abnormalities of the bone tissue,in the far and near end of the mark with a small type of paw truncated rabbit tibial osteomyelitis bone,remove the diseased bone a total of 34 cases,compiled number and corresponds to the mother,using random numbers The patients were divided into two groups: group A and group B(n = 17).Group A was treated with conventional iodine for 30 min,twice daily for 7 days.Group B was treated with conventional iodine In the full immersion soaking 30 min,twice daily for 7 days;and every day after irrigation and soaking after the use of saline rinse,and scraping a little bone tissue to do bacterial culture,and record the number of diseased bacteria strains;7 days after the removal B and B were treated with 0.9% saline,and the rinsing fluid was taken for bacteriological examination.Bacteriological examination was performed on the diseased bone tissue.At the same time,the two groups were treated with histopathological examination.According to the results,The difference in bactericidal effect of different ways of using povidone-iodine.Results:1 after the death of the body due to death of the three rabbits,imaging examination,general observation,pathological examination to evaluate the success of modeling,3 rabbits appear false positive,do not meet the diagnosis of chronic osteomyelitis,a total of 34 rabbits modeling success.2 A and B groups of different methods of iodophor can achieve effective sterilization effect.3 According to the bacteriologic examination of the two groups at the same time point,the number of diseased bacteria in group A was slightly lower than that in group B at 2 days before treatment with iodophor,but the difference was not statistically significant The number of pathogenic bacteria in bacterial culture was significantly lower than that in group B,and the difference was statistically significant.The differences between the two groups were statistically significant.The two groups were treated with pathology Group positive rate lower than the B group,the difference was statistically significant,suggesting that iodophor irrigation bactericidal effect better.Conclusion:1 New Zealand white rabbits through the tibial window cavity into the staphylococcus aureus and sodium glycinate can be successfully produced into the tibial chronic osteomyelitis model2 Iodophor on chronic osteomyelitis pathogens have a good killing effect,and the use of iodophor continuous lavage of rabbits with chronic osteomyelitis bactericidal effect than the use of iodophor completely immersion effect is good,worthy of clinical promotion and use.