Articles | Volume 11, issue 4
https://doi.org/10.5194/jbji-11-493-2026
https://doi.org/10.5194/jbji-11-493-2026
Original full-length article
 | 
13 Aug 2026
Original full-length article |  | 13 Aug 2026

In vitro analysis of antiseptic solution effects on Staphylococcus aureus biofilms on orthopedic implant materials

Madison Balagtas, Kenneth Chrulski, Marina Feffer, Matthew Baldridge, and Ashley E. Levack

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Cited articles

Akens, M. K., Chien, C., Katchky, R. N., Kreder, H. J., Finkelstein, J., and Whyne, C. M.: The impact of thermal cycling on Staphylococcus aureus biofilm growth on stainless steel and titanium orthopaedic plates, BMC Musculoskelet. Disord., 19, 260, https://doi.org/10.1186/s12891-018-2199-z, 2018. 
Arciola, C. R., Campoccia, D., and Montanaro, L.: Implant infections: adhesion, biofilm formation, and immune evasion, Nat. Rev. Microbiol., 16, 397–409, https://doi.org/10.1038/s41579-018-0019-y, 2018. 
Brown, N. M., Cipriano, C. A., Moric, M., Sporer, S. M., and Della Valle, C. J.: Dilute betadine lavage before closure for the prevention of acute postoperative deep periprosthetic joint infection, J. Arthroplasty, 27, 27–30, https://doi.org/10.1016/j.arth.2011.03.034, 2012. 
Chao, C. A., Khilnani, T. K., Jo, S., Shenoy, A., Bostrom, M. P. G., and Carli, A. V.: Not all antiseptic solutions are equivalent in removing biofilm: a comparison across different orthopaedic surfaces, J. Bone Joint Surg. Am., 107, 127–133, https://doi.org/10.2106/JBJS.23.01118, 2025. 
Depypere, M., Kuehl, R., Metsemakers, W. J., Senneville, E., McNally, M. A., Obremskey, W. T., Zimmerli, W., Atkins, B. L., and Trampuz, A.; Fracture-Related Infection (FRI) Consensus Group: Recommendations for systemic antimicrobial therapy in fracture-related infection: a consensus from an international expert group, J. Orthop. Trauma, 34, 30–41, https://doi.org/10.1097/BOT.0000000000001626, 2020. 
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Short summary

Bacterial infections on orthopedic implants are difficult to treat because bacteria form protective biofilms. We tested antiseptic solutions against Staphylococcus aureus biofilms on stainless steel. Povidone-iodine achieved the greatest reduction, exceeding 99.9% bacterial killing. Dilute povidone-iodine performed as well as full-strength, important since lower concentrations reduce tissue toxicity. Hypochlorous acid and chlorhexidine showed lower activity, while saline was minimally effective.

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