{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T14:14:05Z","timestamp":1778249645917,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,18]],"date-time":"2025-05-18T00:00:00Z","timestamp":1747526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AR071985"],"award-info":[{"award-number":["R01 AR071985"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AR071985"],"award-info":[{"award-number":["R01 AR071985"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004410","name":"Scientific and Technological Research Council of Turkey","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004410","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the impact of povidone\u2010iodine, chlorhexidine, vancomycin, and teicoplanin on the size and biomechanical properties of porcine flexor tendon grafts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Porcine deep digital flexor tendons (N = 120) were collected in pairs and allocated into povidone\u2010iodine, chlorhexidine, vancomycin, teicoplanin, and saline solution groups (12 pairs per solution). The tendons from one side underwent a 30\u2010minute soaking in these solutions, whereas those from the other side were wrapped in saline solution\u2013soaked gauze. Tendon cross\u2010sectional area (CSA) was measured before and after soaking, along with unsoaked controls. Tensile testing to failure was performed. Stiffness, load at failure, modulus, and stress at failure were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Soaking in povidone\u2010iodine and chlorhexidine decreased the average CSA by 8% (\u20130.9 mm\n                      <jats:sup>2<\/jats:sup>\n                      [95% confidence interval (CI), \u20131.7 to \u20130.2 mm\n                      <jats:sup>2<\/jats:sup>\n                      ],\n                      <jats:italic>P<\/jats:italic>\n                      = .02) and 13% (\u20131.1 mm\n                      <jats:sup>2<\/jats:sup>\n                      [95% CI, \u20131.5 to \u20130.7 mm\n                      <jats:sup>2<\/jats:sup>\n                      ],\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), respectively. Conversely, the average CSA increased by 12% after soaking in teicoplanin (1.0 mm\n                      <jats:sup>2<\/jats:sup>\n                      [95% CI, 0.7 to 1.3 mm\n                      <jats:sup>2<\/jats:sup>\n                      ],\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and by 6% after soaking in vancomycin (0.7 mm\n                      <jats:sup>2<\/jats:sup>\n                      [95% CI, 0.2 to 1.2 mm\n                      <jats:sup>2<\/jats:sup>\n                      ],\n                      <jats:italic>P<\/jats:italic>\n                      = .01), similar to saline solution (11% increase; 0.8 mm\n                      <jats:sup>2<\/jats:sup>\n                      [95% CI, 0.4 to 1.1 mm\n                      <jats:sup>2<\/jats:sup>\n                      ],\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). The stiffness of tendons soaked in chlorhexidine was 8% lower than that of unsoaked contralateral controls (\u201313.3 N\/mm [95% CI, \u201331.0 to \u20136.9 N\/mm],\n                      <jats:italic>P<\/jats:italic>\n                      = .01), but stress at failure increased by 15% (8.9 MPa [95% CI, 0.6 to 17.2 MPa],\n                      <jats:italic>P<\/jats:italic>\n                      = .04). We observed no significant difference in tensile properties due to soaking in other solutions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Soaking porcine flexor tendons in povidone\u2010iodine and chlorhexidine resulted in a decrease in CSA, whereas soaking in vancomycin and teicoplanin led to an increase, similar to saline solution. No significant side\u2010to\u2010side differences in average CSA were observed. Soaking in chlorhexidine decreased stiffness but increased stress at failure. None of the solutions affected load at failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>It is important to understand the impact of soaking porcine flexor tendon grafts in various antimicrobial solutions to ensure that there are no harmful biomechanical effects to the tissues used in the clinical setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2025.101168","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T18:33:59Z","timestamp":1747852439000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Soaking in Povidone\u2010Iodine, Chlorhexidine, Teicoplanin, Vancomycin, and Saline Solution Differentially Alters Porcine Flexor Tendon Size and Biomechanical Properties"],"prefix":"10.1002","volume":"7","author":[{"given":"Kaan","family":"Gurbuz","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology Kayseri Medical Faculty University of Health Sciences Kayseri Turkey"},{"name":"Lampe Joint Department of Biomedical Engineering North Carolina State University and University of North Carolina at Chapel Hill Raleigh North Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Lampe Joint Department of Biomedical Engineering North Carolina State University and University of North Carolina at Chapel Hill Raleigh North Carolina U.S.A."},{"name":"Comparative Medicine Institute North Carolina State University Raleigh North Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Logan","family":"Opperman","sequence":"additional","affiliation":[{"name":"Department of Statistics North Carolina State University Raleigh North Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew B.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Lampe Joint Department of Biomedical Engineering North Carolina State University and University of North Carolina at Chapel Hill Raleigh North Carolina U.S.A."},{"name":"Comparative Medicine Institute North Carolina State University Raleigh North Carolina 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Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America.","name":"copyright","label":"Copyright"}],"article-number":"101168"}}