When the tendon autograft drops accidently on the floor: A study about bacterial contamination and antiseptic efficacy
O. Barbier, J. Danis, G. Versier, D. Ollat
The Knee
Available online 11 August 2014
Abstract
Background
Inadvertent contamination of the autograft could occur during ACL reconstruction if the autograft drops on the floor during surgery. A study was undertaken to determine the incidence of contamination when a graft dropped on the operating room floor and the efficacy of antimicrobial solutions to decontaminate it.
Methods
Samples from 25 patients undergoing ACL reconstruction with a hamstring tendon were sectioned and dropped onto the floor. Cultures were taken after immersion in an antiseptic solutions (a chlorhexidine gluconate solution (group 1), a povidone-iodine solution (group 2), a sodium-hypochlorite solution (group 3). A fourth piece (group 0) was cultured without being exposed to any solution. Cultures of a floor swab were taken at the same time.
Results
The floor swab cultures were positive in 96% of cases. The rate of contamination was 40% in group 0, 8% in group 1, 4% in group 2, and 16% in group 3. There was a significant difference between groups 1–2 and 0 (p < 0,05) but not between group 3 and 0.
Conclusion
Immersing a graft dropped onto the floor during surgery into in a chlorhexidine gluconate solution or povidone-iodine solution significantly reduces contamination of the graft. Soaking of the hamstring autograft in one of theses solutions is recommended in case of inadvertent contamination.
Clinical relevance: laboratory investigation (level 2)
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