Are Dropped Bone Grafts Safe to be Re-used? - An Experimental Study Comparing Efficacy of Chlorhexidine, Povidone-Iodine and Alcohol
https://doi.org/10.5704/MOJ.2107.011
- Author:
Mat-Salleh MF
1
;
Sadagatullah AN
1
;
Ibrahim MY
2
;
Abdul-Aziz I
2
;
Wan-Abdullah WA
2
;
Maning N
3
;
Md-Hassan MN
2
;
Ab-Rashid MR
2
Author Information
1. Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia
2. Department of Orthopaedics, Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia
3. Department of Pathology, Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia
- Publication Type:Journal Article
- Keywords:
contaminated bones, chlorhexidine, disinfectant
- From:Malaysian Orthopaedic Journal
2021;15(No.2):70-76
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: A dilemma arises when a bone graft or
fracture fragment is accidentally dropped on the operation
theatre floor and becomes contaminated. This study aimed to
determine the efficacy of simple and readily available
antiseptic solutions in disinfecting contaminated bones.
Materials and methods: This experimental study involved
225 bone specimens prepared from discarded bone
fragments during a series of 45 knee and hip arthroplasty
surgeries. The bone fragments were cut into five identical
cubes and were randomly assigned to either control (positive
or negative), or experimental groups (0.5% chlorhexidine,
10% povidone-iodine or 70% alcohol). The control negative
was to determine pre-contamination culture. All bone
specimens, except the control negative group were uniformly
contaminated by dropping on the operation theatre floor.
Subsequently, the dropped bone specimens except for the
control positive group, were disinfected by immersing in a
respective antiseptic solution for 10 minutes, before
transported to the microbiology laboratory for incubation.
Results: The incidence of a positive culture from a dropped
bone fragment was 86.5%. From the 37 specimens sent for
each group, the incidence of positive culture was 5.4% (2
specimens) after being disinfected using chlorhexidine,
67.6% (25 specimens) using povidone-iodine and 81.1% (30
specimens) using alcohol. Simple logistic regression analysis
demonstrated that chlorhexidine was significantly effective
in disinfecting contaminated bones (p-value <0.001, odd
ratio 0.009). Povidone-iodine and alcohol were not
statistically significant (p-value 0.059 and 0.53,
respectively). Organisms identified were Bacillus species
and coagulase negative Staphylococcus. No gram-negative
bacteria were isolated.
Conclusion: A total of 0.5% chlorhexidine is effective and
superior in disinfecting contaminated bones.
- Full text:16.2021my1177.pdf
