Surgical Time Is More Predictive of Suture Contamination During Arthroscopic Rotator Cuff Repair Compared With Skin-Preparation Method: A Prospective Randomized Study on Male Patients.
Hideki Kamijo, Keisuke Matsuki, Norimasa Takahashi et al.
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In 30 seconds
This Level I prospective randomized study compared povidone-iodine, alcohol-containing povidone-iodine, and olanexidine gluconate for preventing suture contamination during arthroscopic rotator cuff repair in 150 male patients. Cutibacterium acnes was cultured from 92 shoulders (61%), with no significant difference in C. acnes-positive rates among antiseptics. Overall bacterial contamination was higher with olanexidine than with alcohol-containing povidone-iodine (odds ratio, 3.82; P = .013). Shorter surgical and suture exposure times were associated with less contamination, while contamination was not related to retear.
Key findings
- C. acnes was detected in 92 shoulders (61%); its positive rate did not differ significantly among the three antiseptic groups.
- Overall bacterial contamination was higher with olanexidine than with alcohol-containing povidone-iodine (odds ratio, 3.82; P = .013).
- Shorter surgical and suture exposure times were associated with lower contamination rates.
- Suture contamination was not related to rotator cuff retear.
Why it matters
Suture contamination is common in this surgical setting, particularly with C. acnes. The findings distinguish antiseptic performance for overall bacterial contamination from performance against C. acnes specifically, and identify operative and suture exposure time as factors associated with contamination. The absence of a detected relationship with retear also helps frame the clinical significance of positive cultures without establishing that contamination is harmless.
What to keep in mind
The study included only male patients undergoing arthroscopic rotator cuff repair, limiting generalizability to other populations and procedures.