Bacterial contamination of Irrigation fluid and suture mater
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In the sterile reservoir, irrigation fluid from the surgical site accumulates during knee arthroscopy. It is unknown if these fluid collections and even suture material used during the arthroscopic surgical processes indicate bacterial contamination during surgery over time. This study aimed to evaluate this rate of contamination and to examine its potential effect on postoperative infection.

In this study, 155 patients were included. 58 patients underwent reconstruction of the anterior cruciate ligament (ACL), 63 patients underwent meniscal surgery and 34 patients combined ACL reconstruction and meniscus repair. Pooled samples of irrigation fluid were collected from the reservoir on the sterile drape every 15 min during the surgery. In addition, researchers evaluated suture material of ACL graft and meniscus repair for bacterial contamination. Samples were sent for microbiological analysis, incubation time was 14 days.

All patients were seen in the outpatient department 6, 12 weeks and 12 months postoperatively and examined for clinical signs of infection.

-- A strong statistical correlation (R2=0.81) was found between an advanced duration of surgery and the number of positive microbiological findings in the accumulated fluid.
-- Suture and fixation material showed a contamination rate of 28.4%.
--Despite the high contamination rate, only one infection was found in the follow-up examinations, caused by Staphylococcus lugdunensis.

Conclusively, since bacterial contamination of accumulated fluid increases over time the contact with the fluid reservoirs should be avoided.