前交叉韧带重建术前进行与不进行皮肤清洁时，皮肤污染情况无显著差异。
No significant difference in skin contamination during anterior cruciate ligament reconstruction with and without preoperative skin cleaning.
作者信息
Bartek Benjamin, Völkner Alexandra, Oehme Stephan, Fahy Stephen, Winkler Tobias, Jung Tobias
机构信息
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany.
Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2025 May;33(5):1728-1735. doi: 10.1002/ksa.12476. Epub 2024 Oct 3.
PURPOSE
This prospective study aimed to assess whether preoperative antiseptic skin cleansing reduces bacterial contamination and surgical site infections (SSI) following anterior cruciate ligament reconstruction (ACLR). We hypothesized that antiseptic cleaning would lower bacterial load, reducing contamination and early infections.
METHODS
One hundred and nineteen patients scheduled for ACLR were included in this prospective, nonrandomized study. Individuals were divided into two groups. Patients in the intervention group applied octenisan® wash lotion daily for three days before surgery and used the wash solution instead of their usual shower gel. Additionally, they swiped their leg with octenisan® soaked gloves on the morning of the operation. The control group followed their usual wash routine with no specific instructions. Fluid samples were taken before surgery from the irrigation bag and at 15-min intervals from the reservoir of the sterile surgical drape during the procedure. Suture material used for the ACL graft and meniscus repair were also collected for testing. The samples were subjected to a 14-day incubation period. Follow-up included outpatient visits at 6 weeks, 12 weeks and 6 months with a final evaluation at 12 months.
RESULTS
Contamination rates showed no significant difference between the control and intervention groups. The mean contamination rate in the control group was 6.4% (n = 22) and 6.6% (n = 24) in the intervention group (p = 0.28). At 12-month follow-up, 110 out of 119 participants were included (52 control, 58 intervention). T tests for age (p = 0.19), BMI (p = 0.66), and surgery duration (p = 0.38) showed no significant differences. No early SSI were observed in either group postoperatively.
CONCLUSION
Our results indicate that the use of antiseptic wash lotion and gloves does not influence the risk of bacterial contamination during surgery.
LEVEL OF EVIDENCE
Level III.
目的
本前瞻性研究旨在评估术前皮肤抗菌清洁是否能减少前交叉韧带重建（ACLR）术后的细菌污染和手术部位感染（SSI）。我们假设抗菌清洁会降低细菌载量，减少污染和早期感染。
方法
119例计划进行ACLR的患者纳入了这项前瞻性、非随机研究。个体被分为两组。干预组患者在手术前三天每天使用奥替尼啶洗液，并使用该清洗液代替其常用的沐浴露。此外，他们在手术当天早晨用浸有奥替尼啶的手套擦拭腿部。对照组按照其常规清洗程序，没有特殊指示。在手术前从冲洗袋中采集液体样本，并在手术过程中每隔15分钟从无菌手术单的储液器中采集样本。用于ACL移植物和半月板修复的缝合材料也被收集用于检测。样本进行14天的培养期。随访包括在6周、12周和6个月时的门诊就诊，并在12个月时进行最终评估。
结果
对照组和干预组之间的污染率没有显著差异。对照组的平均污染率为6.4%（n = 22），干预组为6.6%（n = 24）（p = 0.28）。在12个月的随访中，119名参与者中有110名被纳入（52名对照组，58名干预组）。年龄（p = 0.19）、BMI（p = 0.66）和手术持续时间（p = 0.38）的t检验显示没有显著差异。术后两组均未观察到早期SSI。
结论
我们的结果表明，使用抗菌洗液和手套不会影响手术期间细菌污染的风险。
证据级别
三级。
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