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Related Experiment Videos

Should we use a separate knife for the skin?

O S Schindler1, R F Spencer, M D Smith

  • 1Droitwich Knee Clinic, St Andrews Road, Droitwich Spa, Worcestershire WR9 8YX, UK. schindler@doctors.net.uk

The Journal of Bone and Joint Surgery. British Volume
|February 25, 2006
PubMed
Summary

Using separate skin and inside knives in orthopedic surgery is safer than a one-knife technique. This study found significant bacterial contamination on skin blades, suggesting separate knives prevent deeper infections and reduce the risk of costly peri-prosthetic infections.

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Area of Science:

  • Orthopaedic Surgery
  • Infection Control
  • Microbiology

Background:

  • The 'one-knife technique' versus separate skin and inside knives for elective orthopaedic surgery is debated.
  • Peri-prosthetic infections, often caused by coagulase-negative staphylococci and propionibacterium species, have significant human and financial costs.

Purpose of the Study:

  • To re-assess the safety of the 'one-knife technique' compared to using separate skin and inside knives.
  • To determine the bacterial contamination rates of knife blades used in elective orthopaedic surgery.

Main Methods:

  • Culturing 609 knife blades (skin, inside, control) from 203 elective orthopaedic operations.
  • Utilizing direct and enrichment media for bacterial growth detection.

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Main Results:

  • Bacterial growth was observed on 15.3% of skin blades, 10.8% of inside blades, and 6.4% of control blades.
  • Only 9.7% of contaminated skin blades shared the same organism as their corresponding inside blade.
  • Predominant organisms cultured were coagulase-negative staphylococci and propionibacterium species.

Conclusions:

  • The use of separate skin and inside knives should be maintained as good medical practice.
  • The study suggests separate knives may prevent deeper tissue contamination, mitigating the risk of peri-prosthetic infections.