Microbiologic and Histologic Assessment of Intentional Bacterial Contamination of Bone Grafts

Are Dropped Osteoarticular Bone Fragments Safely Reimplantable in Vivo?

“…Previously studied decontamination techniques have included mechanical scrubbing, serial dilution, exposure to various antibacterial agents, and autoclaving 4,8,[10][11][12][13][14] . Previous studies have been limited as they have not tested osteoarticular fragments (which have a different contamination risk when compared with bone-tendon grafts), have not focused on the range of bacteria likely encountered on the operating room floor, and have not rigorously tested the impact of decontamination on cell viability 12,[14][15][16][17] . The present study was designed as a three-phase investigation to identify a readily employable, scientifically justified, intraoperative management scheme for the surgeon who is faced with a contaminated but nondisposable autologous osteoarticular bone fragment.…”

Successful Immediate Re-implantation of an Extruded Femoral Segment: A Case Report

“…Since then, several authors described their successful experiences with different sterilization techniques including boiling, autoclaving, gamma irradiation, and soaking in chlorhexidine, povidone-iodine, and antibiotic solutions [3][4][5][6][7][8][9][10][11][12][13]. Autoclaving seems to be the most efficient method of decontamination but there are multiple concerns regarding loss of graft osteoinductive properties [4,14]. Due to the fact that data regarding the efficacy of different sterilization techniques cannot provide a clear guide as to which technique is ultimately superior, we do not believe that the type of sterilization solution used will accurately predict the outcome.…”

Effect of Local Rifamycin Application on Expression of BMP-2 and Bone Regeneration

“…Previous studies reported rifamycin may positively affect bone tissue, extraction socket healing, and osteomyelitis treatment. [16][17][18][19] In the literature, there is a little knowledge about the effect of antibiotics on BMP expression. Previously Ufuk et al 20 reported rifamycin is a suitable solution for bone decontamination and may induce BMP-2 expression.…”

“…22,23 On the other hand; previous studies and our study demonstrate higher osteoblast counts, enhanced bone formation 19 , high tolerance by bone 17,18 , and no histological damage. 16 Cytotoxicity may associated with dose, concentration, the type of antimicrobial and exposure time. 2 The selection of appropriate local antibiotics should consider antimicrobial effects, cytotoxicity, concentration and dosage factors.…”

“…16,18 There is little information available regarding the relationship between antibiotic delivery and tissue regeneration. Recently, local delivery growth factors or antibiotics delivered from an implanted biomaterial have been used as novel approaches to stimulate bone regeneration areas of infected bone or compromised bone healing.…”