Abstract
BackgroundDuring drilling of bone, which is common in clinical surgeries, heat generation increases local temperature in the drilling site. Transmission of excessive heat to the surrounding bone tissue can cause thermal osteonecrosis. Consequently, it may lead to failure of implants and fixation screws or delay in healing process. Using cooling is a method for limiting temperature elevation.Materials and methodsIn this study, through comparing three conditions of drilling without cooling, external cooling with normal saline, and external cooling with OpSite spray, the efficiency of OpSite as coolant is studied. In this regard, 2 drill bit diameters, 3 drilling speeds, and 3 drilling feed-rates are considered as drilling variables in the experiments.ResultsFor the whole experiments, while cooling with normal saline resulted in lower maximum temperatures than without cooling condition, OpSite had even better results and limited the temperature elevation during drilling of bone efficiently.ConclusionOpSite spray, which has lower infection risks than normal saline on one hand and lower maximum temperature rise with all combinations of drilling parameters on the other hand, can be considered in clinical surgeries for cooling applications.
Highlights
During drilling of bone, which is common in orthopaedic surgeries and prosthodontics [1], plastic deformation of bone chips, friction between the bone and drill bit, and friction between chips and hole wall cause heat generation in the region [2, 3]
For the whole experiments, while cooling with normal saline resulted in lower maximum temperatures than without cooling condition, OpSite had even better results and limited the temperature elevation during drilling of bone efficiently
In order to control the heat generation in drilling site, while there were positive results for external irrigation in the literature [6, 8, 16, 17], there is a risk of infection for common cooling fluids in orthopedic surgery which restricts their usage [3]
Summary
During drilling of bone, which is common in orthopaedic surgeries and prosthodontics [1], plastic deformation of bone chips, friction between the bone and drill bit, and friction between chips and hole wall cause heat generation in the region [2, 3]. The generated heat increases temperature and can cause thermal osteonecrosis which is death of bone cells (osteocytes) due to thermal overload [4]. It increases risks of failure of implants or delay in healing process. OpSite is a bio-compatible adherent polyurethane film which is waterproof and permeable to Effatparvar et al Journal of Orthopaedic Surgery and Research (2020) 15:197 water vapor and oxygen [18]. It has clinical applications for providing moist wound environment in superficial wounds and for secondary dressing.
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