Center for Musculoskeletal Surgery, Charitéplatz 1, 10117, Berlin, Germany.
Julius Wolff Institute, Berlin, Germany.
Knee Surg Sports Traumatol Arthrosc. 2022 Jan;30(1):246-252. doi: 10.1007/s00167-021-06481-3. Epub 2021 Feb 10.
During knee arthroscopy, irrigation fluid from the surgical site accumulates in the sterile reservoir. Whether these fluid collections and also suture material used during the arthroscopic surgical processes show bacterial contamination over time during surgery remains unclear. The purpose of this study was to determine this contamination rate and to analyze its possible influence on postoperative infection.
In this study, 155 patients were included. Fifty-eight underwent reconstruction of the anterior cruciate ligament (ACL), 63 meniscal surgery and 34 patients combined ACL reconstruction and meniscus repair. We collected pooled samples of irrigation fluid from the reservoir on the sterile drape every 15 min during the surgery. In addition, we evaluated suture material of ACL graft and meniscus repair for bacterial contamination. Samples were sent for microbiological analysis, incubation time was 14 days. All patients were seen in the outpatient department 6, 12 weeks and 12 months postoperatively and examined for clinical signs of infection.
A strong statistical correlation (R = 0.81, p = 0.015) was found between an advanced duration of surgery and the number of positive microbiological findings in the accumulated fluid. Suture and fixation material showed a contamination rate of 28.4% (29 cases). Despite the high contamination rate, only one infection was found in the follow-up examinations, caused by Staphylococcus lugdunensis.
Since bacterial contamination of accumulated fluid increases over time the contact with the fluid reservoirs should be avoided.
IV.
在膝关节镜检查期间，来自手术部位的冲洗液会积聚在无菌储液器中。在手术过程中，这些积液以及关节镜手术过程中使用的缝线材料是否会随着时间的推移而发生细菌污染尚不清楚。本研究的目的是确定这种污染率，并分析其对术后感染的可能影响。
本研究纳入了 155 例患者。58 例行前交叉韧带（ACL）重建，63 例行半月板手术，34 例患者行 ACL 重建和半月板修复。我们每 15 分钟从无菌巾上的储液器中收集一次冲洗液的混合样本。此外，我们评估了 ACL 移植物和半月板修复缝线材料的细菌污染情况。对样本进行微生物分析，孵育时间为 14 天。所有患者术后 6、12 周和 12 个月在门诊进行随访，并检查感染的临床体征。
手术时间延长与积聚液中阳性微生物学发现的数量之间存在很强的统计学相关性（R=0.81，p=0.015）。缝线和固定材料的污染率为 28.4%（29 例）。尽管污染率很高，但在随访检查中仅发现一例感染，由金黄色葡萄球菌引起。
由于积聚液中的细菌污染会随着时间的推移而增加，因此应避免接触储液器。
IV。
