Cartilage on the floor: how effective is antibiotic sterilization?

OBJECTIVE To determine the incidence of positive cultures from contaminated nasal cartilage and to demonstrate the effectiveness of antibiotic irrigation as a means of sterilization. DESIGN A prospective study. SETTING Tertiary referral centre. METHODS Nasal septal cartilage was harvested during routine endoscopic septoplasties. The harvested cartilage was then dropped on the floor for 60 seconds. The cartilage was then divided into four equal portions, which were then divided into four experimental groups: (1) untreated, (2) normal saline soak for 60 seconds, (3) 40 mg/mL gentamicin solution soak for 60 seconds, and (4) 300 seconds. All specimens were sent for bacterial culture and sensitivity, along with nasal swabs and floor swabs. The incidence of bacterial contamination in the different groups was analyzed using the McNemar hypothesis. MAIN OUTCOME MEASURES Correlation between bacterial culture results and treatments of contaminated nasal septal cartilages. RESULTS Thirty-two patients were enrolled in this study. Thirty-one percent of the untreated specimens had bacterial contamination. Thirty-one percent of the saline-soaked specimens had significant bacterial growth. Bacterial growth was not observed in any of the specimens treated with gentamicin irrigation for 60 seconds (absolute reduction of 31%); one specimen (3%) in the 300 seconds gentamicin group had a positive culture. A correlation of 70% was observed in the bacterial growth observed in the swab of the operating room floor and the untreated cartilage. CONCLUSIONS When no other options are available, this study demonstrates that cartilage dropped on the floor can be decontaminated by washing with gentamicin.