title: Hamstring graft bacterial contamination during anterior cruciate ligament reconstruction: clinical and microbiological study.
abstract: Autograft preparation for anterior cruciate ligament (ACL) reconstruction has a potential for graft contamination. The purpose of this study was to evaluate the possibility of bacterial contamination of hamstring autograft during preparation and when dropped onto the operating room floor and methods of graft decontamination.
  
  
  
  Sixty hamstring tendon autograft specimens were used as the test group. Excess tendon not used in the ACL procedure was divided into five segments. One segment, at the completion of preparation, was sent for culture as a control; the remaining four segments were dropped onto the floor adjacent to the surgical field for 15 seconds. One segment was cultured without undergoing any further treatment. Cultures were taken from each segment after immersion in 10 % povidone-iodine solution, 4 % chlorhexidine and bacitracin, respectively, for three minutes. Cultures of a skin swab and floor swab were taken at the same time and place that the ACL was dropped.
  
  
  
  Cultures of control graft tissue from ten patients (16.7 %) were positive for bacteria. No patient developed post-operative infection. Ninety organisms were identified, with Staphylococcus epidermidis being the most common isolate. Grafts rinsed in either bacitracin or 4 % chlorhexidine solutions were less likely to be culture positive.
  
  
  
  A high rate of contamination can be expected during autograft preparation for ACL reconstruction. Soaking the hamstring autograft in either bacitracin or 4 % chlorhexidine solution is effective for decontamination, particulary if graft is dropped on the floor.
authors.affiliation: Department of Medical Microbiology and Immunology, Mansoura University, Mansoura, Egypt. maboelnour@gmail.com.|Faculty of Medicine, Mansoura University, Mansoura, Egypt. maboelnour@gmail.com.
authors.forename: Mohamad Aboelnour
authors.initials: MA
authors.lastname: Badran
authors.affiliation: Department of Orthopedics and Traumatology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.|Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Dalia Mohamed
authors.initials: DM
authors.lastname: Moemen
mesh_terms: D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects*; D001419:Bacteria / Q000302:isolation & purification*; D002710:Chlorhexidine / Q000627:therapeutic use*; D004202:Disinfectants / Q000627:therapeutic use*; D000070633:Hamstring Muscles / Q000382:microbiology*; D006801:Humans; D013710:Tendons; D014182:Transplantation, Autologous
chemical_list: D004202:Disinfectants; D002710:Chlorhexidine
keywords: ACL; Autograft; Contamination; Hamstring; Infection; Sterilisation