Tsai Yao-Hung, Chen Hung-Yen, Huang Tsung-Yu, Chen Jiun-Liang, Kuo Liang-Tseng, Huang Kuo-Chin
Department of Orthopaedic Surgery, Chia-Yi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.
College of Medicine, Chang Gung University at Taoyuan, Taoyuan 33302, Taiwan.
Diagnostics (Basel). 2023 Dec 20;14(1):15. doi: 10.3390/diagnostics14010015.
Allografts have been frequently used in orthopedic procedures. The purposes of this study were to evaluate the discard rates and bacterial contamination of a bone bank, and to assess the clinical outcomes of recipients with bacterial culture-positive donor allografts.
We retrospectively reviewed 1764 allografts which were harvested from living donors and stored in a bone bank from 2018 to 2022. The donors whose allografts displayed bacterial contamination at retrieval of the primary hip or knee arthroplasty were followed for microbiology and subsequent prosthetic joint infection analysis. The infected pathogens, antibiotic treatment and subsequent infection were reviewed for the intraoperative positive culture group.
The discard rate was 17%, and the bacterial contamination rate of bone retrieval was 2.15%. Thirty-eight allografts at retrieval displayed confirmed bacterial growth, and 37 patients did not reveal infective signs at 6 months follow-up. A total of 1464 allografts were stored and implanted, among which 28 allografts (1.91%) were confirmed to be positive for bacterial growth and 13 cases (0.89%) were confirmed as surgical site infections.
Our results validate the suggestion that our bone bank system performs good quality monitoring to eliminate the risk of dissemination of viral and bacterial diseases and to decrease surgical site infection after allograft implantation. By ensuring aseptic conditions and contamination-reducing strategies during harvesting and thawing, the allografts can be safely stored and implanted while limiting bacterial contamination. Our findings confirm that the intraoperative positive cultures of allografts did not contribute to subsequent postoperative surgical site infection in donors and recipients.
同种异体移植物在骨科手术中经常被使用。本研究的目的是评估骨库的废弃率和细菌污染情况，并评估接受细菌培养阳性供体同种异体移植物的受者的临床结局。
我们回顾性分析了2018年至2022年从活体供体获取并储存在骨库中的1764例同种异体移植物。对在初次髋关节或膝关节置换术取出时显示细菌污染的移植物的供体进行微生物学及随后的人工关节感染分析。对术中培养阳性组的感染病原体、抗生素治疗及随后的感染情况进行了回顾。
废弃率为17%，骨取出时的细菌污染率为2.15%。38例移植物在取出时显示有确诊的细菌生长，37例患者在6个月随访时未出现感染迹象。总共储存并植入了1464例同种异体移植物，其中28例（1.91%）被确认为细菌生长阳性，13例（0.89%）被确认为手术部位感染。
我们的结果证实了我们的骨库系统进行了高质量监测以消除病毒和细菌疾病传播风险并降低同种异体移植术后手术部位感染的说法。通过在采集和解冻过程中确保无菌条件和减少污染的策略，同种异体移植物可以安全储存和植入，同时限制细菌污染。我们的研究结果证实，同种异体移植物术中培养阳性与供体和受者随后的术后手术部位感染无关。
