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Bacterial Contamination in Tips of Electrocautery Devices During Total Hip Arthroplasty
Alisina Shahi1, Antonia F Chen1, Paul B McKenna1
1Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.
Abstract:
Surgical equipment can become contaminated during surgery. It is unknown if electrocautery tips can become contaminated in clean orthopedic procedures despite the produced heat. Therefore, we conducted a prospective study to address this concern. The tips from 25 primary and 25 aseptic revision THAs were collected and an additional 5 sterile tips served as negative controls. Aerobic and anaerobic cultures were incubated for a minimum of 3 days. There were 3 positive cultures (6%); one in primary THA (4%) with Lactobacillus and Enterococcus faecalis; two among revisions (8%), one with E. faecalis and another one with alpha hemolytic streptococci and coagulase negative Staphylococcus. The mean exposure time of the contaminated tips was 132.3 minutes. Patients were followed for 90 days postoperatively and none of them developed surgical site infection. This is the first study to demonstrate that electrosurgical devices can become contaminated during THA in laminar flow equipped operating rooms.
Insights
Electrosurgery tips can become contaminated during total hip arthroplasty (THA), even in sterile operating rooms. However, this contamination did not lead to any surgical site infections in the study cohort.
Area of Science:
- Orthopedic Surgery
- Infection Control
- Surgical Technology
Background:
- Surgical equipment poses a risk of contamination during procedures.
- The potential for electrocautery tip contamination in clean orthopedic surgeries, despite high temperatures, remains unclear.
Purpose of the Study:
- To prospectively investigate the contamination of electrocautery tips during total hip arthroplasty (THA).
- To determine the incidence and types of microbial contamination on electrocautery tips in a controlled orthopedic setting.
Main Methods:
- Prospective collection of electrocautery tips from 25 primary and 25 revision THAs.
- Inclusion of 5 sterile tips as negative controls.
- Aerobic and anaerobic incubation of cultures for at least 3 days.
Main Results:
- Three positive cultures (6%) were identified: one in primary THA (4%) and two in revision THA (8%).
- Identified microorganisms included Lactobacillus, Enterococcus faecalis, alpha hemolytic streptococci, and coagulase-negative Staphylococcus.
- Mean exposure time for contaminated tips was 132.3 minutes.
Conclusions:
- Electrosurgical devices can acquire microbial contamination during THA procedures in laminar flow operating rooms.
- Despite observed contamination, no surgical site infections occurred within 90 days postoperatively.
- This study provides the first evidence of electrosurgical device contamination during THA.
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