A rare and uncommon complication after use of hydrogen peroxide (H2O2): A review of use of H2O2 in orthopaedics

Hydrogen peroxide (H2O2) is a commonly used chemical agent in orthopaedic practice for antisepsis, haemostasis and preparation of bone bed for cementation. However, the associated risks of H2O2 usage are not widely known. We report a case of suspected air embolism after use of H2O2 during drainage o...

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Published inJournal of orthopaedics, trauma and rehabilitation Vol. 27; no. 2; pp. 247 - 251
Main Authors Chan, Michael Matthew, Tse, Tao Sun Tycus, Wan, Yik-Cheung Samuel, Wah Hung, Yuk, Fan, Jason CH
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.12.2020
Subjects
Air embolism
oxygen embolism
H2O2
gas embolism
hydrogen peroxide
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Summary:Hydrogen peroxide (H2O2) is a commonly used chemical agent in orthopaedic practice for antisepsis, haemostasis and preparation of bone bed for cementation. However, the associated risks of H2O2 usage are not widely known. We report a case of suspected air embolism after use of H2O2 during drainage of a septic arthritis of the shoulder. Upon our literature review, we were able to demonstrate H2O2 to be beneficial in antisepsis and care of chronic wounds. However, it has not been proven to be superior to other antiseptics commonly used in orthopaedic surgery. Regarding its use in cementation, there is evidence to show it is more effective than saline however, the use of pulsatile lavage appears to be the most important factor affecting the quality of cementation. H2O2 has not been shown to be helpful with haemostasis. Prior to the use of H2O2, one should be cautious and understand its associated risks and precautions.
ISSN:2210-4917
2210-4925
DOI:10.1177/2210491720925089