Izquierdo Rolando, Cadet Edwin R, Bauer Rebecca, Stanwood Walter, Levine William N, Ahmad Christopher S
Crystal Lake Professional Center, Crystal Lake, Illinois, USA.
Arthroscopy. 2005 Nov;21(11):1348-53. doi: 10.1016/j.arthro.2005.08.014.
To survey leaders in sports medicine who perform anterior cruciate ligament (ACL) reconstructions to determine the preferred management when ACL graft contamination occurs.
Survey study of expert opinions and experiences on the management of ACL graft contamination.
We mailed 337 surveys to directors of academic sports medicine programs and graduates from an accredited sports medicine fellowship. The survey questioned the incidence, treatment, and outcome of ACL graft contamination.
Twelve surveys were returned to sender; 196 surgeons responded from the remaining 325 surveys (60%). Forty-nine of 196 (25%) surgeons reported at least 1 contamination during their career. Of those 49, 43 surgeons (88%) had 1 contaminated graft, 5 (10%) had 2, and 1 had 4, for a total of 57 reported contaminated grafts. Of the surgeons who reported a contaminated graft, 22 (45%) performed between 40 and 100 ACL reconstructions annually, and 17 (35%) performed more than 100 ACL reconstructions annually. Forty-three of the 57 (75%) contaminated grafts were managed with cleansing of the graft and proceeding with reconstruction. Ten (18%) were managed by harvesting a different graft, and 4 (7%) were substituted with an allograft. No infections in any of the contaminated grafts were reported. Sixty-five of the 147 (43%) surgeons without graft contamination gave hypothetical management responses. Thirty-eight (58%) would cleanse the graft and proceed with the procedure, 22 (34%) would harvest a different graft, and 5 (8%) would use an allograft.
Surgeons who perform a high volume of ACL reconstruction surgery most often choose graft cleansing as the preferred management for intraoperative ACL graft contamination.
Level V, expert opinion.
对进行前交叉韧带（ACL）重建手术的运动医学领域领导者展开调查，以确定ACL移植物发生污染时的首选处理方式。
关于ACL移植物污染处理的专家意见与经验的调查研究。
我们向学术性运动医学项目的主任以及经认可的运动医学专科培训项目的毕业生邮寄了337份调查问卷。该问卷涉及ACL移植物污染的发生率、治疗方法及结果。
12份问卷被退回；其余325份问卷中有196位外科医生回复（60%）。196位外科医生中有49位（25%）报告在其职业生涯中至少发生过1次污染。在这49位医生中，43位（88%）有1个移植物被污染，5位（10%）有2个，1位有4个，总计报告有57个移植物被污染。在报告有移植物被污染的外科医生中，22位（45%）每年进行40至100例ACL重建手术，17位（35%）每年进行超过100例ACL重建手术。57个被污染的移植物中有43个（75%）通过清洗移植物并继续进行重建来处理。10个（18%）通过获取不同的移植物来处理，4个（7%）用同种异体移植物替代。未报告任何被污染移植物发生感染。147位未发生移植物污染的外科医生中有65位（43%）给出了假设性的处理回复。38位（58%）会清洗移植物并继续手术，22位（34%）会获取不同的移植物，5位（8%）会使用同种异体移植物。
进行大量ACL重建手术的外科医生最常选择清洗移植物作为术中ACL移植物污染的首选处理方式。
V级，专家意见。
