Incidence of bacterial contamination and predisposing factors during bone and tendon allograft procurement
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ORIGINAL PAPER
Incidence of bacterial contamination and predisposing factors during bone and tendon allograft procurement Clara Terzaghi • Alessia Longo • Claudio Legnani • Davide Paolo Bernasconi Maristella Fare´
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Received: 18 September 2013 / Accepted: 5 May 2014 Ó Springer Science+Business Media Dordrecht 2014
Abstract The aim of this study was to analyze factors contributing to bacteriological contamination of bone and tendon allograft. Between 2008 and 2011, 2,778 bone and tendon allografts obtained from 196 organ and tissue donors or tissue donors only were retrospectively analysed. Several variables were taken into account: donor type (organ and tissue donors vs. tissue donor), cause of death, time interval between death and tissue procurement, duration of the procurement procedure, type of allografts, number of team members, number of trainees members, associated surgical procedures, positivity to haemoculture, type of procurement. The overall incidence of graft contamination was 23 %. The cause of death, the procurement time, the duration of procurement, the associated surgical procedures were not associated with increased risk of contamination. Significant effect on contamination incidence was observed for the number of staff members performing the procurement. In addition, our study substantiated significantly C. Terzaghi (&) A. Longo M. Fare´ Musculoskeletal Tissue Bank of Milan, G. Pini Orthopaedic Institute , Milan, Italy e-mail: [email protected] C. Terzaghi C. Legnani Minimally Invasive Articular Surgery Unit, G. Pini Orthopaedic Institute, Milan, Italy D. P. Bernasconi Department of Health Sciences, University of MilanBicocca, Monza, Italy
higher contamination rate among bone allografts than from tendon grafts. According to these observations, in order to minimize the contamination rate of procured musculoskeletal allografts, we recommend appropriate donor selection, use of standard sterile techniques, immediate packaging of each allograft to reduce graft exposure. Allograft procurement should be performed by a small surgical team. Keywords Allograft Bacterial contamination Procurement Tissue banking
Introduction The transplant of musculoskelatal allograft tissue in reconstructive orthopaedic surgery has markedly increased in the last few years. With the increasing demand of allograft, it has became necessary to provide regulation and clear set of standards. Multiorgan and multitissue donors offer a large quantity and high quality of bone and soft-tissue grafts. Allografts represent an attractive alternative to autogenous tissue as they reduce the morbidity in the donor-site. However, contamination of allografts during procurement represents a relevant complication since pathogenic microorganisms may be responsible for disease transmission (Journeaux et al. 1999; Eastlund 2006; Bohatyrewicz et al. 2002). Therefore, tissue banks must provide safe and effective allografts
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(Ivory and Thomas 1993; No authors listed 2004, 2006). Allograft retrieval cont
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