Purpose

To survey members of The ACL study group to determine the current practice patterns surrounding the technique of pre-soaking ACL grafts in vancomycin.

Methods

A web-based questionnaire was distributed to members of the ACL Study Group. Questions included the use of vancomycin solution for graft soaking during ACL reconstruction, their protocol for soaking the graft, vancomycin concentration utilized, graft choices, and concerns with the technique.

Results

Sixty-six (57%) ACL surgeons completed the survey. Approximately one-third (37.9%) of respondents currently pre-soak their ACL grafts in vancomycin prior to implantation, with 60% of these surgeons being from Europe. Seventy-six percent have adopted this practice within the past 5 years. The majority of surgeons wrap the graft in a vancomycin-soaked gauze prior to implantation (56%), soak for a variable amount of time before implantation (56%), use a concentration of 5 mg/mL (68%), and soak hamstring grafts (92%). Concerns included the mechanical properties of the graft (35%), cost of vancomycin (23%), availability (12%), and antibiotic resistance (9%).

Conclusion

This survey demonstrates that 37.9% of ACL study group members currently utilize vancomycin to pre-soak ACL tendon grafts as a means to decrease post-operative infection risk, with the majority of surgeons having implemented this practice within the past 5 years. The biggest concern towards using vancomycin was the mechanical properties of the graft after soaking.

Level of evidence

IV.

中文翻译：

---

万古霉素预浸泡ACL肌腱移植的外科医生实践模式：ACL研究组的调查。

目的

对ACL研究小组的成员进行调查，以确定围绕在万古霉素中预浸泡ACL移植物技术的当前实践模式。

方法

基于Web的调查表已分发给ACL研究组的成员。问题包括在ACL重建过程中使用万古霉素溶液进行嫁接浸泡，浸泡协议的使用方案，使用的万古霉素浓度，嫁接剂选择以及对技术的关注。

结果

六十六（57％）名ACL外科医生完成了调查。目前，约有三分之一（37.9％）的受访者在植入前将其ACL移植物预先浸泡在万古霉素中，其中60％来自欧洲。在过去的5年中，百分之七十六采用了这种做法。大多数外科医生在植入前将植入物包裹在浸泡了万古霉素的纱布中（56％），在植入前浸泡可变时间（56％），使用5 mg / mL的浓度（68％），然后浸泡绳肌移植（92％）。关注的问题包括移植物的机械性能（35％），万古霉素的成本（23％），可用性（12％）和抗生素耐药性（9％）。

结论

这项调查表明，目前有37.9％的ACL研究小组成员利用万古霉素预浸泡ACL肌腱移植物，以降低术后感染的风险，而且大多数外科医生在过去5年中都采用了这种做法。使用万古霉素的最大问题是浸泡后移植物的机械性能。

证据水平

IV。