Testing of Different Digestion Solutions on Tissue Samples and the Effects of Used Potassium Hydroxide Solution on Polystyrene Microspheres

Microplastic particles are ubiquitous in our environment, having entered the air, the water, the soil, and ultimately our food chain. Owing to their small size, these particles can potentially enter the bloodstream and accumulate in the organs. To detect microplastics using existing methods, they must first be isolated. The aim of this study was to develop a non-destructive method for efficiently and affordably isolating plastic particles. We investigated the digestion of kidney, lung, liver, and brain samples from pigs. Kidney samples were analyzed using light microscopy after incubation with proteinase K, pepsin/pancreatin, and 10% potassium hydroxide (KOH) solution. Various KOH:tissue ratios were employed for the digestion of lung, liver, and brain samples. Additionally, we examined the effect of 10% KOH solution on added polystyrene microplastics using scanning electron microscopy. Our findings revealed that a 10% KOH solution is the most suitable for dissolving diverse organ samples, while enzymatic methods require further refinement. Moreover, we demonstrated that commonly used 1 µm polystyrene particles remain unaffected by 10% KOH solution even after 76 h of incubation. Digestion by KOH offers a simple and cost-effective approach for processing organ samples and holds potential for isolating plastic particles from meat products.

Surgical Site Infection in Patients Managed with an Endoprosthesis for the Treatment of Cancer: Evaluation of Patient, Disease, and Index Surgical Factors

BACKGROUND

Surgical site infection (SSI) after segmental endoprosthetic reconstruction in patients treated for oncologic conditions remains both a devastating and a common complication. The goal of the present study was to identify variables associated with the success or failure of treatment of early SSI following the treatment of a primary bone tumor with use of a segmental endoprosthesis.

METHODS

The present study used the Prophylactic Antibiotic Regimens in Tumor Surgery (PARITY) data set to identify patients who had been diagnosed with an SSI after undergoing endoprosthetic reconstruction of a lower extremity primary bone tumor. The primary outcome of interest in the present study was a dichotomous variable: the success or failure of infection treatment. We defined failure as the inability to eradicate the infection, which we considered as an outcome of amputation or limb retention with chronic antibiotic suppression (>90 days or ongoing therapy at the conclusion of the study). Multivariable models were created with covariates of interest for each of the following: surgery characteristics, cancer treatment-related characteristics, and tumor characteristics. Multivariable testing included variables selected on the basis of known associations with infection or results of the univariable tests.

RESULTS

Of the 96 patients who were diagnosed with an SSI, 27 (28%) had successful eradication of the infection and 69 had treatment failure. Baseline and index procedure variables showing significant association with SSI treatment outcome were moderate/large amounts of fascial excision ≥1 cm2) (OR, 10.21 [95% CI, 2.65 to 46.21]; p = 0.001), use of local muscle/skin graft (OR,11.88 [95% CI, 1.83 to 245.83]; p = 0.031), and use of a deep Hemovac (OR, 0.24 [95% CI, 0.05 to 0.85]; p = 0.041). In the final multivariable model, excision of fascia during primary tumor resection was the only variable with a significant association with treatment outcome (OR, 10.21 [95% CI, 2.65 to 46.21]; p = 0.018).

CONCLUSIONS

The results of this secondary analysis of the PARITY trial data provide further insight into the patient-, disease-, and treatment-specific associations with SSI treatment outcomes, which may help to inform decision-making and management of SSI in patients who have undergone segmental bone reconstruction of the femur or tibia for oncologic indications.

LEVEL OF EVIDENCE

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.