A study of the clinical incidence of infection in the use of banked allograft bone.

To determine the incidence of infection in grafting procedures utilizing banked allograft bone, 567 questionnaires were sent to collaborating surgeons who used Navy Tissue Bank freeze-dried allograft bone from October 1973 to October 1976. Three hundred and three questionnaires were sufficiently completed to be included in the study. Twenty-one patients were reported as showing evidence of infection, of which twelve were considered minor and nine were considered major according to the effect on the patient's postoperative course. In eleven of the twenty-one patients there were positive cultures as proof of infection: in the remaining ten there were not. Analysis of the proved infections showed that the allograft was probably not primarily responsible in most of the patients. Based on the data obtained in this study, the incidence of infection with the use of banked allogenous bone appears to compare favorably with infection rates reported for orthopaedic procedures utilizing autogenous bone.

The effect of devascularization on the regeneration of lacerated peripheral nerves: an experimental study.

The functional, biochemical, and histological changes in a severed median nerve, 9 months after epineurial repair, were studied in 14 monkeys. In seven the mesoneurium had been stripped 5 cm proximal and 5 cm distal to the site of repair, and in seven the nerve had been stripped only over a 0.5 cm area, just enough to allow repair. In the first group the mean muscular strength in the abductor pollicis brevis was 197 gm, as compared to 257 gm in the second group. The amount of collagen in the perineurium was 57 microgram/mg, as compared to 43 microgram/mg, and the incidence of the h-l-h-nl cross-link was 16% to 21%, as compared to 9% to 11%. If the regeneration of the lacerated nerve was compromised by the deposition of collagen resulting from mobilization of the distal segment, as suggested by the decrease in the strength of the abductor pollicis brevis muscle, then any mobilization of a nerve necessary to obtain a sutured junction with minimum tension should be limited to the proximal segment.