ABSTRACT
OBJECTIVE: To evaluate the effect of topically applied dimethylsulfoxide (DMSO) on lipopolysaccharide (LPS)-induced synovitis in the mid-carpal joint. ANIMALS: 6 sound, healthy, adult horses (12 carpi). PROCEDURE: In a double-blinded, crossover, paired study with a 1-week washout period, mid-carpal joints were allocated to group 1 (DMSO, n = 6) or group 2 (control, n = 6). Each joint was injected with 1.3 ml (0.0125 ng/dl) of LPS to induce synovitis. For group-1 joints, DMSO gel (15 g; 90%) was applied after injection of LPS and at 12-hour intervals for 60 hours. Joints of group 2 received LPS, but not DMSO gel. All horses were evaluated by serial lameness examinations and synovial fluid analyses (total and differential WBC count and total protein concentration) at 12-hour intervals for 60 hours after LPS injection. Plasma and synovial fluid were obtained at baseline and 36 hours to document presence of DMSO. RESULTS: Mean WBC concentration was significantly (P < 0.05) lower in group-1, compared with group-2 joints, at 24 hours and had a trend to be lower at 36 hours. Mean total neutrophil count was significantly lower in group-1, compared with group-2 joints at 24 hours. In group-1 joints, DMSO was detected by use of gas chromatography in the synovial fluid of 5 of 6 joints and in plasma from 1 of 6 horses. CONCLUSION: Topically applied DMSO penetrated into synovial fluid in sufficient quantities to be detected and to decrease joint inflammation.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Dimethyl Sulfoxide/therapeutic use , Horse Diseases/drug therapy , Lipopolysaccharides , Synovitis/veterinary , Administration, Topical , Animals , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/pharmacokinetics , Cross-Over Studies , Dimethyl Sulfoxide/administration & dosage , Dimethyl Sulfoxide/pharmacokinetics , Double-Blind Method , Gels , Horses , Lameness, Animal/drug therapy , Lameness, Animal/etiology , Leukocyte Count/veterinary , Synovial Fluid/cytology , Synovitis/chemically induced , Synovitis/complications , Synovitis/drug therapyABSTRACT
To determine which type of irrigation solution and which method of irrigation most effectively removes slime-producing Staphylococcus from implant surfaces, we performed experimental washings of bacteria-coated stainless steel screws with various solutions delivered by bulb syringe or by jet lavage. The quantity of bacteria remaining on the screw surface was determined after irrigation with 1 L of saline, 1 L of antibiotic solutions, or 1 L of saline containing a liquid soap. Antibiotic solutions tested included bacitracin, neomycin, and polymyxin/neomycin. We found that the use of power irrigation increased the removal of bacteria by a factor of at least 100 over bulb syringe irrigation of the same volume, no matter which solution was used. This effect ranged from a 100-fold improvement for neomycin, to a 285-fold effect for the polymyxin solution. The addition of antibiotic drugs to the irrigation solution had no significant effect on bacterial removal, and none of the antibiotic solutions were statistically different from saline alone in the amount of bacteria removed from the screws. The addition of a liquid soap solution dramatically increased the amount of bacteria removed by irrigation, reducing the residual bacteria per screw from a colony count of 3.5 x 10(4) for polymyxin (the best of the antibiotic solutions), to 4.38 x 10(3). This difference was statistically significant as judged by Student's t test, with p = 0.01. We have concluded that the use of power irrigation improves the ability to clean this pathogenic bacteria from metallic surfaces, and that the addition of antibiotic drugs to the irrigation solution does not.(ABSTRACT TRUNCATED AT 250 WORDS)
