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High bacterial contamination rate of electrocautery tips during total hip and knee arthroplasty

Hussein Abdelaziz1, Akos Zahar1, Christian Lausmann1

  • 1Department of Orthopaedic Surgery, Helios ENDO-Klinik, Holstenstr. 2, 22767, Hamburg, Germany.

International Orthopaedics
|February 14, 2018
PubMed
Abstract

Insights

Bacterial contamination of electrocautery tips is common during total joint replacement (TJR), particularly in septic revisions. Changing tips after debriding infected tissue is recommended to reduce infection risk.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Control
  • Surgical Instrumentation

Background:

  • Electrocautery is widely used in total joint replacement (TJR) surgery.
  • Contamination of surgical instruments can lead to surgical site infections.
  • Quantifying bacterial contamination of electrocautery tips is crucial for infection prevention strategies.

Purpose of the Study:

  • To determine the bacterial contamination rate of electrocautery tips during primary, aseptic revision, and septic revision TJR procedures.
  • To analyze the correlation between bacterial contamination and the type of TJR surgery.

Main Methods:

  • 150 electrocautery tips were collected from TJR surgeries (primary, aseptic revision, septic revision).
  • Each surgical group contributed 50 electrocautery tips.
  • Bacterial contamination rates were determined, and exposure time and surgery type were analyzed.

Main Results:

  • The overall bacterial contamination rate was 14.7%.
  • Septic revision TJR showed the highest contamination rate (30.0%), followed by primary TJR (10.0%) and aseptic revision TJR (4.0%).
  • In septic revisions, 80% of contaminated tips harbored the same microorganism causing the joint infection.

Conclusions:

  • Electrocautery tip contamination is a significant concern, especially in septic revision TJR.
  • A high rate of contamination in septic revisions suggests potential for intraoperative bacterial spread.
  • Recommendations include changing electrocautery tips after debriding infected tissue to mitigate infection transmission.
Keywords:
BacterialElectrocautery tipsIntra-operative contaminationPeriprosthetic joint infection (PJI)Surgical site infection (SSI)Total hip arthroplastyTotal knee arthroplasty

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