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Intraoperative bacterial contamination in operations for joint replacement.
N Davis1, A Curry, A K Gambhir
1Bone Infection Group, University of Manchester, North Manchester General Hospital, England, UK.
The Journal of Bone and Joint Surgery. British Volume
|October 26, 1999
Summary
Surgical site contamination is common during hip and knee arthroplasty, with bacteria found on instruments, gloves, and gowns. This study highlights potential infection risks and suggests practice changes for orthopedic surgery.
Area of Science:
- Orthopedic Surgery
- Microbiology
- Infection Control
Background:
- Surgical instruments and operating room supplies can harbor bacteria, posing a risk of contamination during orthopedic procedures.
- Understanding microbial contamination is crucial for preventing surgical site infections (SSIs) in joint replacement surgeries.
Purpose of the Study:
- To quantify the prevalence and identify sources of microbial contamination during elective primary hip and knee arthroplasties.
- To establish a baseline for future studies on the bacteriology of revision arthroplasty.
Main Methods:
- Collection and microbiological analysis of samples from 100 elective primary hip and knee arthroplasties.
- Sampling included surgical instruments (sucker tips, light handles, blades), gloves, theatre gowns, needles, and collection bags.
- Identification of bacterial organisms and assessment of contamination rates across different items and procedures.
Main Results:
- Significant contamination rates were observed: sucker tips (11.4%), light handles (14.5%), skin blades (9.4%), inside blades (3.2%), preparation gloves (28.7%), collection bags (20%), theatre gowns (17%), and closure needles (10%).
- Coagulase-negative staphylococcus was the predominant organism (76%).
- Overall, 63% of operations showed contamination within the surgical field.
Conclusions:
- Microbial contamination is prevalent during primary hip and knee arthroplasty, originating from various sources including instruments and personnel.
- The findings underscore the need for enhanced infection control measures and suggest potential practice modifications to minimize bacterial exposure.
- The study provides essential baseline data for investigating the bacteriology of revision arthroplasty and improving patient outcomes.