The contaminated skin-knife--fact or fiction

Area of Science:

• Orthopaedic Surgery
• Surgical Infection Control
• Microbiology

Background:

• Surgical site infections (SSIs) are a significant concern in orthopaedic surgery.
• Bacterial contamination of surgical instruments, such as scalpels, can contribute to SSIs.
• Practices aimed at reducing instrument contamination are crucial for patient safety.

Purpose of the Study:

• To evaluate the effectiveness of discarding the skin-knife after initial incision on reducing SSIs.
• To assess the impact of laminar airflow on surgical knife bacterial contamination.

Main Methods:

• A prospective study involving 358 patients undergoing clean orthopaedic surgery.
• Bacteriological examination of the skin-knife and the final knife used during surgery.
• Comparison of infection rates between groups with and without discarding the skin-knife.
• Assessment of knife contamination levels under laminar airflow conditions.

Main Results:

• No significant difference in wound infection incidence was observed when the skin-knife was discarded.
• Laminar airflow significantly reduced the rate of bacterial contamination on surgical knives.
• Specific data on the bacterial load and types of microorganisms were collected.

Conclusions:

• Discarding the skin-knife after initial incision is not an effective strategy for preventing SSIs in clean orthopaedic procedures.
• Laminar airflow is an effective environmental control measure for reducing surgical knife contamination.
• Further research may explore combined strategies for optimal surgical site infection prevention.