Higher concentrations of chlorhexidine, a common and efficient disinfectant, may damage graft collagen and cell viability in tendons used for anterior cruciate ligament reconstruction, according to study results.
Researchers conducted the biochemical study to determine if there were any adverse effects of the anterior cruciate ligament (ACL) decontamination solution chlorhexidine (CLX) on treated ACL grafts. Researchers prepared collagen fibrils to test CLX at varying concentrations (0%, 0.5%, 2%, and 4%) on collagen degradation and dissolution. A solution of reverse osmosis water without CLX served as a control. The collagen fibrils were then incubated with 50 mcL of each CLX concentration for intervals of 10, 20, and 40 minutes. The CLX was removed, and the fibrils were removed with a centrifuge. This process was repeated with each concentration of CLX for a 20-minute period.
Gel electrophoresis analysis of the collagen fibrils showed no significant effects with the control solution or the CLX concentrations at 0.5% and 2% at any time interval. Four percent CLX concentration, however, affected the fibrils in short incubation periods, with noticeable fibril dissolution.
“Using 4% CLX can result in marked fibril dissolution and decreased cell viability and metabolic activity,” researchers said, adding it “definitely should be avoided for use as a disinfectant. Two percent CLX can be used to disinfect contaminated ACL grafts, but such treatment will drastically reduce the metabolic activity of the cells within the graft.”