title: When the tendon autograft is dropped accidently on the floor: A study about bacterial contamination and antiseptic efficacy.
abstract: BACKGROUND
  Inadvertent contamination of the autograft can occur during anterior cruciate ligament (ACL) reconstruction if the autograft is dropped on the floor during surgery. A study was undertaken to determine the incidence of contamination when a graft is dropped on the operating room floor and the efficacy of antimicrobial solutions to decontaminate it.
  
  
  METHODS
  Samples from 25 patients undergoing ACL reconstruction with a hamstring tendon were sectioned and dropped onto the floor. Cultures were taken after immersion in antiseptic solutions (a chlorhexidine gluconate solution (group 1), a povidone-iodine solution (group 2), and a sodium hypochlorite solution (group 3)). A fourth piece (group 0) was cultured without being exposed to any solution. Cultures of a floor swab were taken at the same time.
  
  
  RESULTS
  The floor swab cultures were positive in 96% of cases. The rate of contamination was 40% in group 0, 8% in group 1, 4% in group 2, and 16% in group 3. There was a significant difference between groups 1 and 2 and group 0 (p<0.05) but not between groups 3 and 0.
  
  
  CONCLUSIONS
  Immersing a graft dropped on the floor during surgery in a chlorhexidine gluconate solution or povidone-iodine solution significantly reduces contamination of the graft. Soaking of the hamstring autograft in one of these solutions is recommended in the case of inadvertent contamination.
  
  
  CONCLUSIONS
  Laboratory investigation (level 2).
authors.affiliation: Begin Military Hospital, Orthopedic and Traumatology Department, 69 Avenue de Paris, 94160 Saint Mandé, France. Electronic address: olive.barbier@gmail.com.
authors.forename: O
authors.initials: O
authors.lastname: Barbier
authors.affiliation: Begin Military Hospital, Orthopedic and Traumatology Department, 69 Avenue de Paris, 94160 Saint Mandé, France.
authors.forename: J
authors.initials: J
authors.lastname: Danis
authors.affiliation: Begin Military Hospital, Orthopedic and Traumatology Department, 69 Avenue de Paris, 94160 Saint Mandé, France.
authors.forename: G
authors.initials: G
authors.lastname: Versier
authors.affiliation: Begin Military Hospital, Orthopedic and Traumatology Department, 69 Avenue de Paris, 94160 Saint Mandé, France.
authors.forename: D
authors.initials: D
authors.lastname: Ollat
mesh_terms: D056570:Aerococcus / Q000302:isolation & purification; D059549:Anterior Cruciate Ligament Reconstruction; D000891:Anti-Infective Agents, Local; D064592:Autografts / Q000382:microbiology*; D002710:Chlorhexidine / Q000031:analogs & derivatives; D004202:Disinfectants; D004203:Disinfection; D005430:Floors and Floorcoverings; D006801:Humans; D007101:Immersion; D007431:Intraoperative Complications; D009873:Operating Rooms; D011206:Povidone-Iodine; D011446:Prospective Studies; D011549:Pseudomonas / Q000302:isolation & purification; D012973:Sodium Hypochlorite; D013210:Staphylococcus / Q000302:isolation & purification; D013710:Tendons / Q000382:microbiology* / Q000637:transplantation
chemical_list: D000891:Anti-Infective Agents, Local; D004202:Disinfectants; D011206:Povidone-Iodine; D012973:Sodium Hypochlorite; C010882:chlorhexidine gluconate; D002710:Chlorhexidine
keywords: Antiseptic; Contamination; Graft