Background: 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.
Purpose: To compare the sterilization efficiency of 3 disinfectants to decontaminate ACL grafts as necessary.
Study Design: Systematic review.
Methods: 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.
Results: 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).
Conclusion: 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.
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| http://dx.doi.org/10.1177/23259671211002873 | DOI Listing |
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