Temponi Eduardo Frois, Marques da Costa Luís Henrique Grassi, Soares Luiz Fernando Machado, Carvalho Júnior Lúcio Honório de
Hospital Madre Teresa, Belo Horizonte, MG, Brasil.
Faculdade de Medicina, Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Rev Bras Ortop (Sao Paulo). 2019 Feb;54(1):45-52. doi: 10.1016/j.rbo.2017.09.008. Epub 2019 Mar 1.
To evaluate the contamination rate of hamstring tendon autografts by comparing two different techniques, and to verify whether intraoperative contamination is associated with the development of clinical infection in patients submitted to reconstruction of the anterior cruciate ligament (ACL).
A total of 110 hamstring tendon autograft ACL reconstructions were performed and divided into two groups: 1-hamstring tendon retraction technique; and 2 - technique maintaining the tibial insertion of the hamstring tendon. During the preparation, two graft fragments were sent for culturing; the harvesting time, the preparation time, and the total surgery time were measured. Twenty-four hours after the surgery, the C-reactive protein was assayed. The clinical outpatient follow-up was performed up to 180 days postoperatively.
Although there were two postoperative infections, there was no graft contamination or difference between the groups in relation to the graft preparation time and to the 24-hour postoperative C-reactive protein assessment. The classic technique presented a longer graft harvesting time ( = 0.038), and there was no statistical difference between the 2 groups regarding the degree of contamination and consequent clinical infection, although 2 patients in group 2 presented with infection, with negative perioperative cultures.
Based on the results obtained, there was no association between graft contamination and the time or technique of its preparation. In addition, there was also no association between intraoperative contamination and the development of clinical infection, nor was there any sign of an association between the early alteration of C-reactive protein and the onset of infection.
通过比较两种不同技术评估腘绳肌腱自体移植物的污染率,并验证接受前交叉韧带(ACL)重建的患者术中污染是否与临床感染的发生有关。
共进行了110例腘绳肌腱自体移植物ACL重建手术,并分为两组:1-腘绳肌腱牵开技术;2-保留腘绳肌腱胫骨附着点的技术。在准备过程中,将两个移植物碎片送去培养;测量取材时间、准备时间和总手术时间。术后24小时检测C反应蛋白。术后门诊随访至术后180天。
虽然有2例术后感染,但两组在移植物准备时间和术后24小时C反应蛋白评估方面均无移植物污染或差异。经典技术的移植物取材时间更长(P = 0.038),两组在污染程度及随后的临床感染方面无统计学差异,尽管第2组有2例患者出现感染,围手术期培养结果为阴性。
根据所得结果,移植物污染与其准备时间或技术之间无关联。此外,术中污染与临床感染的发生之间也无关联,C反应蛋白早期变化与感染发生之间也无关联迹象。