Hematomas in musculoskeletal tissue donation: do they really increase microbiological risk?

Area of Science:

• Orthopedic Surgery
• Transplantation Science
• Microbiology

Background:

• Musculoskeletal tissues with hematomas from cadaveric donors are often excluded for allograft use due to perceived contamination risk.
• Limited scientific evidence supports the exclusion of hematoma-bearing tissues.
• This practice impacts the availability of allografts for transplantation.

Purpose of the Study:

• To investigate the association between hematoma presence and microbiological contamination in cadaveric musculoskeletal tissues.
• To determine if hematoma is a significant risk factor for microbial contamination in tissues intended for allograft use.
• To provide evidence-based recommendations for tissue banking policies regarding hematoma exclusion criteria.

Main Methods:

• Prospective case-control study involving 234 musculoskeletal tissues from 16 cadaveric donors.
• Data collection included hematoma presence and microbiological culture results for each tissue.
• Statistical analysis utilized Fisher's exact test, odds ratios (OR), and 95% confidence intervals (CI).

Main Results:

• Hematomas were present in 10.7% (25/234) of tissues.
• Overall microbiological positivity was 5.1% (12/234).
• Tissues with hematoma showed 8.0% positivity (2/25) versus 4.8% (10/209) without hematoma; this difference was not statistically significant (p=0.62).

Conclusions:

• Hematoma presence in cadaveric musculoskeletal tissues does not significantly elevate the risk of microbiological contamination.
• Hematoma alone should not be an automatic exclusion criterion for allograft use.
• Further research with larger cohorts is recommended to validate these findings and inform tissue banking policies.