Abstract
Introduction:
When having to remove broken or embedded metal implants using high speed burrs, the consequence is often a significant amount of metal debris which becomes embedded in the soft tissues. This may then act as a source for a foreign body inflammatory reaction or as a third body wear in the situation of joint arthroplasty. We describe a simple, cheap and effective method of reducing this debris using only a sterile water-based lubricating gel.
Materials & Methods:
Several experimental surgical models consisting of porcine muscle over a polyethylene tube with a large fragment titanium locking plate and screw secured to it were constructed. In 8 separate models a screw head locked within the plate was subjected to 90 seconds of high speed burring to create debris. On 4 models no water-based lubricating gel was utilized and on the remaining 4 the surrounding soft tissues were coated in the water-based lubricating gel (AQUAGEL, Halliburton – 42g £1.98). All models were then irrigated with NaCl 500mls using a 20mlsl syringe under manual pressure. Images were then captured after irrigation. The amount of debris was quantified by processing with ImageJ (a public domain, Java-based image processing program developed at the National Institutes of Health and is a computer automated program for counting particles.) The results were then statistically analysed using a student t test (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.).
Results:
the images from the models with water-based gel were shown to have a statistically significant difference in particle number and area within the soft tissues (p=0.001).
Conclusion:
We have shown that using a safe, cheap and easily available water-based lubricating gel reduces the amount of embedded debris when burring metal implants using a high-speed burr.
