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

• Main Authors: Michael Matthew Chan, Tao Sun Tycus Tse, Yik-Cheung Samuel Wan, Yuk Wah Hung, Jason CH Fan
• Format: Article
• Language: English
• Published: SAGE Publishing 2020-12-01
• Series: Journal of Orthopaedics, Trauma and Rehabilitation
• Online Access: https://doi.org/10.1177/2210491720925089

Hydrogen peroxide (H 2 O 2 ) is a commonly used chemical agent in orthopaedic practice for antisepsis, haemostasis and preparation of bone bed for cementation. However, the associated risks of H 2 O 2 usage are not widely known. We report a case of suspected air embolism after use of H 2 O 2 during drainage of a septic arthritis of the shoulder. Upon our literature review, we were able to demonstrate H 2 O 2 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. H 2 O 2 has not been shown to be helpful with haemostasis. Prior to the use of H 2 O 2 , one should be cautious and understand its associated risks and precautions.