Wu C, Hsieh P, Fan Jiang J, Shih H, Chen C, Hu C
Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Da Chien General Hospital, Miaoli, Taiwan.
Bone Joint J. 2015 Mar;97-B(3):427-31. doi: 10.1302/0301-620X.97B3.34600.
Fresh-frozen allograft bone is frequently used in orthopaedic surgery. We investigated the incidence of allograft-related infection and analysed the outcomes of recipients of bacterial culture-positive allografts from our single-institute bone bank during bone transplantation. The fresh-frozen allografts were harvested in a strict sterile environment during total joint arthroplasty surgery and immediately stored in a freezer at -78º to -68º C after packing. Between January 2007 and December 2012, 2024 patients received 2083 allografts with a minimum of 12 months of follow-up. The overall allograft-associated infection rate was 1.2% (24/2024). Swab cultures of 2083 allografts taken before implantation revealed 21 (1.0%) positive findings. The 21 recipients were given various antibiotics at the individual orthopaedic surgeon's discretion. At the latest follow-up, none of these 21 recipients displayed clinical signs of infection following treatment. Based on these findings, we conclude that an incidental positive culture finding for allografts does not correlate with subsequent surgical site infection. Additional prolonged post-operative antibiotic therapy may not be necessary for recipients of fresh-frozen bone allograft with positive culture findings.
新鲜冷冻同种异体骨在骨科手术中经常使用。我们调查了同种异体骨相关感染的发生率，并分析了我们单机构骨库中细菌培养阳性同种异体骨接受者在骨移植期间的结局。新鲜冷冻同种异体骨在全关节置换手术期间于严格无菌环境下采集，包装后立即储存在-78º至-68ºC的冷冻库中。2007年1月至2012年12月期间，2024例患者接受了2083块同种异体骨，随访时间至少12个月。同种异体骨相关感染的总体发生率为1.2%（24/2024）。植入前对2083块同种异体骨进行的拭子培养显示有21例（1.0%）阳性结果。这21名接受者由各自的骨科医生酌情给予了各种抗生素。在最近一次随访时，这21名接受者在治疗后均未表现出感染的临床迹象。基于这些发现，我们得出结论：同种异体骨培养偶然出现阳性结果与随后的手术部位感染无关。对于培养结果呈阳性的新鲜冷冻骨同种异体骨接受者，可能无需额外延长术后抗生素治疗时间。
