title: Surgery for acquired cardiovascular disease: antiseptic treatment of contaminated vein grafts.
abstract: OBJECTIVE
  Saphenous vein grafts harvested for use as bypass conduits can be contaminated intraoperatively, e.g. by being inadvertently dropped to the floor of the operating room (OR). This study was performed to investigate microorganisms most likely contaminating vein grafts and to assess the possible efficacy of measures to treat potentially contaminated vein grafts antiseptically for further use.
  
  
  METHODS
  In a first step we determined the microbiological flora of the OR using surface cultures and cultures from intentionally dropped vein grafts. Several antiseptic agents (PVP-iodine 10%, octenidinhydrochloride 0.1%, polyhexanide 1%) were evaluated for their in vitro efficacy to disinfect artificially contaminated vein segments. The most promising antiseptic regimen was tested on veins contaminated in a real OR setting. Finally, we tested for possible alterations in mechanical properties of the veins caused by antiseptic treatment.
  
  
  RESULTS
  Coagulase-negative staphylococci where the predominant bacteria recovered from the OR with 59.9%. Antiseptic treatment with a combination of octenidine and PVP-iodine resulted in a higher rate of negative cultures than any single agent. Treatment of 50 saphenous vein grafts contaminated in the OR with the combination regimen resulted in only 3 positive cultural results within 7 days. Mechanical tear-stress testing comparing antiseptically treated vein grafts with controls showed no difference in their resistance to tear stress.
  
  
  CONCLUSIONS
  Antiseptic treatment of contaminated vein grafts was shown to be effective in a high percentage of cases without altering mechanical properties of grafts and may be an option for the surgeon in case of a contamination.
authors.affiliation: Second Medical Department University Medical Center Johannes Gutenberg University, Mainz, Germany - bjansen@uni-mainz.de.
authors.forename: F P
authors.initials: FP
authors.lastname: Schmidt
authors.forename: A A
authors.initials: AA
authors.lastname: Peivandi
authors.forename: W
authors.initials: W
authors.lastname: Kohnen
authors.forename: B
authors.initials: B
authors.lastname: Jansen
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D000985:Antisepsis / Q000379:methods*; D001645:Biguanides / Q000627:therapeutic use; D006801:Humans; D007097:Imines; D009873:Operating Rooms; D011206:Povidone-Iodine / Q000627:therapeutic use; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D011725:Pyridines / Q000627:therapeutic use; D012501:Saphenous Vein / Q000187:drug effects* / Q000382:microbiology / Q000637:transplantation*; D013203:Staphylococcal Infections / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D013210:Staphylococcus / Q000187:drug effects* / Q000302:isolation & purification; D013314:Stress, Mechanical; D013718:Tensile Strength; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D001645:Biguanides; D007097:Imines; D011725:Pyridines; C031233:polihexanide; D011206:Povidone-Iodine; C034213:octenidine