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When the tendon autograft is dropped accidently on the floor: A study about bacterial contamination and antiseptic
O Barbier1, J Danis1, G Versier1
1Begin Military Hospital, Orthopedic and Traumatology Department, 69 Avenue de Paris, 94160 Saint Mandé, France.
Background:
Inadvertent contamination of the autograft can occur during anterior cruciate ligament (ACL) reconstruction if the autograft is dropped on the floor during surgery. A study was undertaken to determine the incidence of contamination when a graft is 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 antiseptic solutions (a chlorhexidine gluconate solution (group 1), a povidone-iodine solution (group 2), and 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 and 2 and group 0 (p<0.05) but not between groups 3 and 0.
Conclusions:
Immersing a graft dropped on the floor during surgery in a chlorhexidine gluconate solution or povidone-iodine solution significantly reduces contamination of the graft. Soaking of the hamstring autograft in one of these solutions is recommended in the case of inadvertent contamination.
Clinical Relevance:
Laboratory investigation (level 2).
Insights
Dropping a hamstring autograft during anterior cruciate ligament (ACL) reconstruction can lead to contamination. Immersing the graft in chlorhexidine gluconate or povidone-iodine solutions effectively reduces contamination.
Area of Science:
- Orthopedic surgery
- Microbiology
- Biomedical engineering
Background:
- Autograft contamination during anterior cruciate ligament (ACL) reconstruction is a risk if the graft contacts the operating room floor.
- This study investigates the frequency of graft contamination and the effectiveness of antimicrobial solutions in preventing it.
Purpose of the Study:
- To determine the incidence of contamination when an ACL autograft is dropped on the operating room floor.
- To evaluate the efficacy of different antimicrobial solutions in decontaminating dropped hamstring autografts.
Main Methods:
- Hamstring tendon autografts from 25 patients were intentionally dropped on the floor.
- Samples were immersed in chlorhexidine gluconate, povidone-iodine, or sodium hypochlorite solutions, or no solution (control).
- Cultures assessed contamination rates, alongside floor swab cultures.
Main Results:
- Operating room floor cultures were positive in 96% of cases, indicating a high contamination risk.
- Graft contamination rates were 40% (no solution), 8% (chlorhexidine), 4% (povidone-iodine), and 16% (sodium hypochlorite).
- Chlorhexidine and povidone-iodine significantly reduced contamination compared to the control group (p<0.05).
Conclusions:
- Immersing a dropped hamstring autograft in chlorhexidine gluconate or povidone-iodine solutions significantly mitigates contamination.
- These antiseptic solutions are recommended for use when inadvertent graft contamination occurs during ACL reconstruction surgery.
