Menekse Guner, Kuscu Ferit, Suntur Bedia Mutay, Gezercan Yurdal, Ates Tuncay, Ozsoy Kerem Mazhar, Okten Ali Ihsan
*Department of Neurosurgery, Ankara Training and Research Hospital, Ankara, Turkey †Department of Infectious Diseases and Microbiology, Adana Numune Training and Research Hospital, Adana, Turkey; and ‡Department of Neurosurgery, Adana Numune Training and Research Hospital, Adana, Turkey.
Spine (Phila Pa 1976). 2015 Aug 15;40(16):1247-51. doi: 10.1097/BRS.0000000000000944.
Prospective study OBJECTIVE.: To evaluate contamination in spinal implants using a liquid culture medium and the effect of covering an implant set on contamination.
Postoperative infection rates increase with the use of spinal implants. Because implant contamination may be an important origin for postoperative infections, investigation, evaluation, and taking required precautions to prevent these contaminations are critical.
Patients operated on for various spinal pathologies were randomized. The patients were divided into groups of covered and uncovered implant sets. The screw samples were placed in liquid culture medium immediately after opening the implant set. The implant set in the covered group was immediately covered with a sterile surgical towel. A new screw was taken from the implant set and cultured in the liquid culture medium every 30 minutes. At the end of 24 hours, swabs with samples from the liquid culture medium were used to culture blood agar. At the end of 48 hours, the samples with growth were considered contaminated.
Growth started after 30 minutes in the uncovered group, whereas only a single growth was noted after 60 minutes in the covered group. Contamination increased with time in both groups, but more so in the open group. A statistically significant difference in contamination was found between the groups at and after 30 minutes.
Contamination increases with time in all implant materials. Contamination rates can be reduced by using simple precautions, such as covering the implant set. Culturing the entire implant samples in liquid culture medium is accepted as a safe and more effective method in evaluating contamination.
前瞻性研究
使用液体培养基评估脊柱植入物的污染情况以及覆盖植入套件对污染的影响。
脊柱植入物的使用会使术后感染率增加。由于植入物污染可能是术后感染的重要源头，因此进行调查、评估并采取必要预防措施以防止这些污染至关重要。
对因各种脊柱疾病接受手术的患者进行随机分组。患者被分为植入套件覆盖组和未覆盖组。打开植入套件后，立即将螺钉样本放入液体培养基中。覆盖组的植入套件立即用无菌手术巾覆盖。每隔30分钟从植入套件中取出一颗新螺钉并在液体培养基中培养。24小时结束时，用来自液体培养基的样本拭子培养血琼脂。48小时结束时，有生长的样本被视为受污染。
未覆盖组在30分钟后开始生长，而覆盖组在60分钟后仅出现一次生长。两组的污染均随时间增加，但开放组更为明显。在30分钟及之后，两组之间的污染存在统计学显著差异。
所有植入材料的污染均随时间增加。通过采取简单的预防措施，如覆盖植入套件，可以降低污染率。在评估污染时，将整个植入样本在液体培养基中培养被认为是一种安全且更有效的方法。
2级
