Potential for contamination of orthopaedic implants using individually wrapped screws

Area of Science:

• Orthopaedic Surgery
• Infection Control
• Surgical Instrumentation

Background:

• Shift from screw banks to individually wrapped screws in orthopaedic surgery.
• Hypothesis: Opening individually wrapped items increases contamination risk compared to screw banks.
• Potential for increased patient infection risk due to repeated opening of sterile packages.

Purpose of the Study:

• To evaluate the contamination risk associated with opening individually wrapped surgical screws.
• To compare the contamination potential of individually wrapped screws versus screw banks.
• To inform best practices for sterile technique in orthopaedic surgery.

Main Methods:

• 100 individually wrapped screws were tested for contamination after opening by theatre nurses.
• Glitterbug cream, visible under UV light, was used to simulate contamination transfer.
• Five screw banks were also opened and inspected for comparison using the same method.

Main Results:

• Contamination was identified in one of 100 individually wrapped screws.
• No contamination was observed on the inner packaging of the screw banks.
• Participants did not perceive any contamination during the process.

Conclusions:

• Opening individually wrapped surgical items increases the risk of operative field contamination.
• The move towards individually wrapped components in surgery requires further investigation regarding infection control.
• Orthopaedic operating theatres should consider using screw banks to minimize contamination risk.