Shen Xianyue, Qin Yanguo, Zuo Jianlin, Liu Tong, Xiao Jianlin
Department of Orthopedics, The Second Hospital, Jilin University, Changchun, China.
Department of Orthopedics, China-Japan Union Hospital, Jilin University, Changchun, China.
Orthop J Sports Med. 2021 May 10;9(5):23259671211002873. doi: 10.1177/23259671211002873. eCollection 2021 May.
The inadvertent contamination of anterior cruciate ligament (ACL) grafts can occur if they are accidentally dropped on the floor during ACL reconstruction. There has been no meta-analysis conducted to compare the sterilization efficiency of the different disinfectants used on dropped ACL grafts.
To compare the sterilization efficiency of 3 disinfectants to decontaminate ACL grafts as necessary.
Systematic review.
A systematic literature review was performed using the MEDLINE, Embase, and Cochrane Library databases. All studies reporting the management of dropped or contaminated grafts were considered for this meta-analysis.
A total of 7 studies meeting inclusion criteria were identified from a literature search. The pooled results of this meta-analysis indicated that the rate of positive cultures of ACL grafts dropped on the operating room floor was 44.9% and that the commonly contaminated microbes were staphylococci and bacilli. The meta-analysis results indicated that the sterilization efficiency of a 4% chlorhexidine solution was superior to an antibiotic solution (odds ratio [OR], 0.17 [95% CI, 0.05-0.57]; = .004) and a 10% povidone-iodine solution (OR, 0.04 [95% CI, 0.01-0.20]; < .0001). Further, the antibiotic solution was superior to the 10% povidone-iodine solution (OR, 0.20 [95% CI, 0.07-0.55]; = .002).
The results of our meta-analysis demonstrated that staphylococci and bacilli were the most common contaminants on dropped ACL grafts and that decontamination using a 4% chlorhexidine solution more reliably disinfected ACL grafts. This information can help to guide surgeons as regards appropriate remedial measures.
在前交叉韧带（ACL）重建过程中，如果ACL移植物意外掉落在地上，可能会发生无意污染。目前尚无荟萃分析来比较用于处理掉落的ACL移植物的不同消毒剂的杀菌效率。
必要时比较3种消毒剂对ACL移植物进行去污的杀菌效率。
系统评价。
使用MEDLINE、Embase和Cochrane图书馆数据库进行系统的文献综述。本荟萃分析纳入所有报告处理掉落或污染移植物的研究。
通过文献检索共确定了7项符合纳入标准的研究。该荟萃分析的汇总结果表明，掉落在手术室地面上的ACL移植物的阳性培养率为44.9%，常见的污染微生物为葡萄球菌和杆菌。荟萃分析结果表明，4%氯己定溶液的杀菌效率优于抗生素溶液（优势比[OR]，0.17[95%可信区间，0.05 - 0.57]；P = 0.004）和10%聚维酮碘溶液（OR，0.04[95%可信区间，0.01 - 0.20]；P < 0.0001）。此外，抗生素溶液优于10%聚维酮碘溶液（OR，0.20[95%可信区间，0.07 - 0.55]；P = 0.002）。
我们的荟萃分析结果表明，葡萄球菌和杆菌是掉落的ACL移植物中最常见的污染物，使用4%氯己定溶液进行去污能更可靠地对ACL移植物进行消毒。这些信息有助于指导外科医生采取适当的补救措施。
