Contaminated Rabbit Patellar Tendon Grafts: In Vivo Analysis of Disinfecting Methods

• Published in: The American journal of sports medicine 1994-05, Vol.22 (3), p.387-391
• Main Authors: Goebel, Mark E., Drez, David, Heck, Suzy B., Stoma, Mary Kay
• Format: Article
• Language: English
• Subjects: Animals; Anterior cruciate ligament; Bacteria; Biological and medical sciences; Chlorhexidine - analogs & derivatives; Chlorhexidine - therapeutic use; Clindamycin - administration & dosage; Clindamycin - therapeutic use; Disinfectants - therapeutic use; Disinfection; Drug Combinations; Enterococcus; Enterococcus faecalis; Escherichia coli; Escherichia coli Infections - prevention & control; Female; Gentamicins - administration & dosage; Gentamicins - therapeutic use; Gram-Positive Bacterial Infections - prevention & control; Intraoperative Complications - prevention & control; Klebsiella Infections - prevention & control; Klebsiella pneumoniae; Knee; Male; Medical research; Medical sciences; Methods; Organ transplantation; Orthopedic surgery; Patellar Ligament - microbiology; Patellar Ligament - transplantation; Polymyxins - administration & dosage; Polymyxins - therapeutic use; Povidone-Iodine - therapeutic use; Prevention; Pseudomonas; Pseudomonas aeruginosa; Pseudomonas Infections - prevention & control; Rabbits; Sports medicine; Staphylococcal Infections - prevention & control; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Wound Infection - microbiology; Surgical Wound Infection - prevention & control; Surgical wound infections; Tendon transplantation; Tendons; Tissue transplantation; Transplantation; Transplantation of organs, tissues, etc
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/036354659402200315

In Part 1 of our study, 40 central-third bone-patellar tendon-bone grafts were harvested from 20 adult Cali fornia White rabbits under strict sterile conditions. Ten grafts were placed directly into a thioglycolate broth, incubated, and subcultured; no growth was noted in any specimen. The next 6 grafts were contaminated 20 sec onds each with 2 different species of coagulase negative staphylococci. Organisms were grown with cultures obtained from an operating room floor during anterior cruciate ligament reconstruction. Marked growth of both species was noted in all 6 grafts within 24 hours. A subsequent 3 series of 8 grafts each were harvested sterilely, contaminated as described above, and soaked in 1 of 3 solutions 30 minutes before culture. Both 10% povidone-iodine and a triple-antibiotic solu tion (gentamicin, clindamycin, polymyxin) were 100% ineffective as both organisms grew; 4% chlorhexidine gluconate effectively decontaminated 8 grafts in all cases. Part 2 involved contamination of harvested grafts with 5 common, virulent organisms: Staphylococ cus aureus, Escherichia coli, Pseudomonas aerugi nosa, Klebsiella pneumoniae, and Enterococcus fae calis. Elimination of all except Klebsiella pneumoniae was successful with 4% chlorhexidine gluconate alone for 8 grafts. Using a triple-antibiotic solution after chlor hexidine gluconate in 6 grafts eliminated this organism also.