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Evaluating bacterial contamination of free bone fragments falling to the ground and the effectiveness of antiseptic solutions

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Objectives

This study aims to determine the contamination incidence rate of bone fragments that have been dropped on the floor of the operating theatre, as well as how effective antimicrobial solutions are at decontaminating them.

Methods

Bone fragments obtained after 30 total knee arthroplasties were used in the study. Inert pieces of bone emerging after the bone cuts during total knee arthroplasty were divided into 1 × 1 cm fragments. The bone fragments were first left in free fall on the floor of the operating theatre and then were kept in a number of antimicrobial solutions for 15 s. Subsequently, they were microbiologically and histopathologically examined. A swab culture was also taken from the floor of the operating theatre.

Results

It was determined that 63.3% of osteochondral fragments in the non-intervened group were contaminated. Growth was likewise detected in all swab cultures. Microorganisms growing in the swab culture and the non-intervened group were similar and mostly Staphylococcus epidermidis and Klebsiella pneumoniae. When the growth rates of the 10% povidone-iodine and 4% chlorhexidine gluconate groups were compared with the growth rate of the non-intervened group, a statistical difference was found. No difference was determined between the growth rates of the sodium hypochlorite and the non-intervened groups. The histopathological analysis revealed no statistical difference between the groups in terms of bone marrow, vascular structure, fat tissue, and osteoblastic activity results in the osteochondral fragments

Conclusion

Bone tissues dropped from a sterile area on the floor of the operating theatre are highly contaminated. An effective decontamination without bone cell toxicity was achieved using povidone-iodine. Although chlorhexidine gluconate solution had an effective decontamination effect compared to the non-intervened group, it was not 100% effective. Sodium hypochlorite solution was not effective in the decontamination of grafts under our working conditions.

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Funding

The expenses of all materials used in this study were undertaken by the researcher.

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Samsun Training and Research Hospital, Health Sciences University, Samsun, Turkey

    Harun Altınayak

  2. Department of Medical Microbiology, Pamukkale University, School of Medicine, Çamlaraltı, Pamukkale Ünv. Hastane Yolu, Pamukkale/Denizli , 20070, Turkey

    Sedef Zeliha Öner

  3. Department of Medical Pathology, T. C. Ministry of Health Tokat Provincial Health Directorate Turhal State Hospital, Maraşal Fevzi Çakmak Mah.Nurkavak Cad.No:50, 60300, Turhal/Tokat, Turkey

    Süleyman Özdemir

Authors
  1. Harun Altınayak
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  2. Sedef Zeliha Öner
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  3. Süleyman Özdemir
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Contributions

Study conception and design: HA. Data collection: HA, SZÖ, SÖ. Drafting of the article: HA. Data analysis and interpretation: HA, SZÖ, SÖ. Critical revision of the article: HA.

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Correspondence to Harun Altınayak .

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Altınayak , H., Öner, S.Z. & Özdemir, S. Evaluating bacterial contamination of free bone fragments falling to the ground and the effectiveness of antiseptic solutions. Eur J Orthop Surg Traumatol 32, 459–465 (2022). https://doi.org/10.1007/s00590-021-02978-2

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  • DOI: https://doi.org/10.1007/s00590-021-02978-2

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