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Dadun > Depósito Académico > Clínica Universidad de Navarra > Cirugía ortopédica y traumatología > DA - CUN - Cirugía ortopédica y traumatología - Artículos de revista >

Frozen cancellous bone allografts: positive cultures of implanted grafts in posterior fusions of the spine
Authors: Barriga, A. (Andrés)
Diaz-de-Rada, P. (Pablo)
Barroso, J.L. (José L.)
Alfonso, M. (Matías)
Lamata, M. (M.)
Hernaez, S. (S.)
Beguiristain, J. (José)
San-Julian, M. (Mikel)
Villas, C. (Carlos)
Keywords: Postoperative Complications/drug therapy/microbiology
Spinal Diseases/surgery
Transplantation, Homologous
Issue Date: 2004
Publisher: Springer Verlag
Publisher version: http://www.springerlink.com/content/cm6qwg4mw11jthw4/fulltext.pdf
ISSN: 1432-0932
Citation: Barriga A, Díaz-de-Rada P, Barroso JL, Alfonso M, Lamata M, Hernáez S, Beguiristáin JL, San-Julián M, Villas C. Frozen cancellous bone allografts: positive cultures of implanted grafts in posterior fusions of the spine. Eur Spine J. 2004 Mar;13(2):152-6.
Abstract
We have carried out a study on the behaviour pattern of implanted allografts initially stored in perfect conditions (aseptically processed, culture-negative and stored at -80 degrees C) but which presented positive cultures at the implantation stage. There is no information available on how to deal with this type of situation, so our aim was to set guidelines on the course of action which would be required in such a case. This was a retrospective study of 112 patients who underwent a spinal arthrodesis and in whom a total of 189 allograft pieces were used. All previous bone and blood cultures and tests for hepatitis B and C, syphilis and HIV (via PCR techniques) were negative. The allografts were stored by freezing them at -80 degrees C. A sample of the allograft was taken for culture in the operating theatre just before its implantation in all cases. The results of the cultures were obtained 3-5 days after the operation. There were 22 allografts with positive culture results (12%) after implantation. These allografts were implanted in 16 patients (14%). Cultures were positive for staphylococci coagulase negative (ECN) in 10 grafts (46%), Pseudomonas stutzeri in two grafts (9%), Corynebacterium jeikeium in two grafts (9%), staphylococci coagulase positive in two grafts (9%) and for each of the following organisms in one case each (4%): Corynebacterium spp., Actinomyces odontolyticus, Streptococcus mitis, Peptostreptococcus spp., Rhodococcus equi and Bacillus spp. No clinical infection was seen in any of these patients. Positive cultures could be caused by non-detected contamination at harvesting, storing or during manipulation before implantation. The lack of clinical signs of infection during the follow-up of our patients may indicate that no specific treatment different from our antibiotic protocol is required in the case of positive culture results of a graft piece after implantation.
Permanent link: http://hdl.handle.net/10171/23414
Appears in Collections:DA - Medicina - Microbiología y Parasitología - Artículos de revista
DA - CUN - Cirugía ortopédica y traumatología - Artículos de revista

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