Extrakorporale hydrostatische Hochdruckbehandlung als neues Verfahren zur Desinfektion infizierter Knochenpräparate

Background: Allogeneic bone transplantation is at risk of
infection, and established disinfection methods typically
compromise bone quality. High hydrostatic pressure (HHP) is well
established for disinfection in food technology, and also it does
protect biomechanical and biological properties of bone. This study
is the first investigation of HHP regarding disinfection of bone
biopsies. Materials and methods: Bone biopsies of 34 patients with
chronic infections were subjected to HHP and assessed for
persisting bacterial growth. In series 1, bone biopsies were
proceeded directly to HHP (10 min; maximal pressure P-max 600 MPa).
In series 2, HHP was applied after 5-day incubation in growth media
(10 min or 2 x 30 min; P-max 600 MPa). Furthermore, HHP-induced
changes of bacterial morphology on artificially infected bone
samples were evaluated by scanning electron microscopy (SEM).
Results: For series 1, 71% of the bone samples were sterilised by
HHP (n = 17), compared to 38% of the untreated control samples,
which were obtained during the same surgery (n = 8). For series 2,
after prior incubation, HHP disinfected 7% of the bone specimens (n
= 55), all control samples showed bacterial growth (n = 33).
Destruction of cell wall integrity of Gram-negative strains was
observed by SEM. Conclusion: The effectiveness of HHP for bone
disinfection should be improved by optimising treatment parameters.
Infections with barosensitive Gram-negative bacteria or yeast might
represent possible clinical indications.