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MICROBIOLOGICAL ASSESSMENT OF A FEMORAL HEAD DONOR PROGRAM



Abstract

Introduction: Transmission of infection is always a concern in allograft bone banking and the surgical applications of such bone.

Aim: To review the microbiological results of the femoral head donor program at Perth Bone and Tissue Bank from March 1992 until April 2001.

Methods: There were 4515 femoral head donations. All were cultured by means of a swab and bone chip at time of retrieval, prior to storage at −75 degrees C. Once six month repeat serological testing of donors had been obtained, the heads were processed under sterile conditions. All soft tissues were removed, the bone was milled and washed with 1.5 litres warm saline as pulsed lavage. A microbiological swab was taken prior to packaging the graft ready for irradiation and freezer storage until use.

Results: Five hundred and seventy-nine femoral heads had a positive swab or chip at retrieval, with 31 cases having the same organism on both tests. In 516 cases only one of these tests was positive, with skin organisms being the dominant finding. In 10 cases the swab at the end of processing was positive on culture. Eight of these cases were negative on retrieval testing, and in only one case was the same organism, a coagulase negative staphylococcus, present on the processing swab and retrieval testing.

Conclusions: This work suggested that microbiological culture of femoral head swabs and bone chips at time of retrieval has little effect on the culture at the end of processing. After storage at −75 degrees C, mechanical cleaning and washing, less than 1% of femoral heads were positive prior to irradiation.

The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand