Alomar Abdulaziz Z, Alfayez Saud M, Binnasser Ahmad, Aljassir Fawzi F
Orthopaedic Department, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
McGill University, Division of Orthopedic Surgery, Department of Surgery, Montreal, Quebec, Canada.
Acta Ortop Bras. 2022 Jul 6;30(spe1):e243232. doi: 10.1590/1413-785220223001e243232. eCollection 2022.
Despite numerous articles on intraoperative contamination in total knee arthroplasty (TKA) procedures, the available data on tissue contamination are scarce and mainly based on evaluating bacteriological swabs.
Two hundred and forty specimens, divided between bone and soft tissue, were obtained from 40 consecutive unilateral primaries TKAs. The specimens were evaluated for aerobic and anaerobic bacterial growth. Colony-forming units/gram (CFU/g) were calculated on the contaminated specimens to determine the level of contamination.
The contamination rate in intraoperative specimens was 15% during TKA. The contamination level had a mean of 10.6 and a median of 5, ranging from 1-70 CFU/g. The most common contaminating organisms in all samples were Staphylococcus aureus (38.9%) and Staphylococcus epidermidis (30.6%). No clinical infections were detected in TKAs in the follow-up period.
The contamination rate during TKA is relatively high, despite the practice of standard preventive measures. Contamination levels, measured by CFU/g, are considered low when compared to the infection threshold of 105 reported in the literature. However, contamination should not be underestimated due to the presence of foreign bodies (implants), which are known to significantly lower this threshold. .
尽管有大量关于全膝关节置换术（TKA）术中污染的文章，但关于组织污染的现有数据却很稀少，且主要基于对细菌学拭子的评估。
从40例连续的单侧初次TKA手术中获取了240个标本，分为骨组织和软组织。对标本进行需氧和厌氧细菌生长评估。计算污染标本上的菌落形成单位/克（CFU/g）以确定污染水平。
TKA术中标本的污染率为15%。污染水平的平均值为10.6，中位数为5，范围为1 - 70 CFU/g。所有样本中最常见的污染菌是金黄色葡萄球菌（38.9%）和表皮葡萄球菌（30.6%）。随访期间TKA未检测到临床感染。
尽管采取了标准预防措施，但TKA术中的污染率相对较高。与文献报道的105的感染阈值相比，以CFU/g衡量的污染水平被认为较低。然而，由于存在异物（植入物），污染不应被低估，已知异物会显著降低该阈值。
