Purpose: To begin documenting the prevalence and appropriate management of contaminated autologous grafts in aesthetic plastic surgery.

Methods: An online survey was sent to American Society of Aesthetic Plastic Surgery members to investigate the incidence of autograft contamination, treatment preferences, clinical outcomes, and patient disclosure.

Results: 121 anonymous responses were received, with 67% reporting autograft contamination. Twenty-four percent of surgeons reported 1 incidence, 37% cited 2, 17% experienced 3, and 21% reported 4 or more. Ninety-four percent of contaminated grafts were managed with decontamination and surgery completion. Ten percent of surgeons harvested an alternative graft and 3.6% used an alloplastic substitute. The most common decontamination method was antibiotic solution (57%), followed by povidone-iodine (49%) and bulb saline irrigation (43%). Two patients experienced a wound infection associated with a contaminated graft. In 62.4% of cases, the contamination was not disclosed to the patient.

Discussion: After evaluating survey results and existing literature, an algorithm for tissue-specific decontamination techniques was developed. Also discussed are the medical and ethical dilemmas associated with patient disclosure and proposed solutions.

Conclusion: Autologous graft contamination is common in aesthetic plastic surgery and managed with decontamination in the majority of instances. Contamination causes minimal or no deleterious clinical sequelae.
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