Time-related comparison of scolicidal activity of the different substances used in hydatid cyst

INTRODUCTION: Inactivation of protoscoleces is one of the main principles of treatment in hydatid cysts. The aim of the present study is to evaluate the scolicidal efficacies of some frequently used scolicidal substances in hydatid cyst fluid.
METHODS: Hydatid cyst fluids were aspirated from ten patients during surgical treatments and the interventional radiology procedures. The suitable cyst fluids were examined for interactions with 0.9% NaCl, 15% NaCl, 10% povidone-iodine, savlon, crystalline, and 0.4% chlorhexidine gluconate (Chx-Glu), respectively. Scoleces in the mixtures were counted at minutes 2, 5, 10 and 20. The ratio of the number of living scoleces / total scoleces was calculated. Normal distribution of numerical data was analyzed using the Shapiro - Wilk test. ANOVA and LSD tests were used in the comparison of variables.
RESULTS: There were significant differences between each scolicidal substances and time in terms of the ratio of living scoleces (p<0.05). But all scolicidal substances failed to kill all of the scoleces in the second and fifth minutes. There were significant differences between Chx-Glu and other scolicidal substances in the second minute apart from povidone-iodine, and 99% of the scolexes died at 5 minutes with Chx-Glu. Chx-Glu, savlon, and 10% povidone-iodine showed full efficacy in minute 10. Crystalline and 15% NaCl were able to reach full efficacy in minute 20.
DISCUSSION AND CONCLUSION: The efficacy of all substances was increasing with the waiting period. As soon as possible, the fastest active substance Chx-Glu seems to be used in conservative surgical interventions.