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Updated: Feb 5, 2026

Combined In vivo Optical and µCT Imaging to Monitor Infection, Inflammation, and Bone Anatomy in an Orthopaedic Implant Infection in Mice
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Reprocessing safety issues associated with complex-design orthopaedic loaned surgical instruments and implants.

Dayane de Melo Costa1, Lillian Kelly de Oliveira Lopes2, Karen Vickery3

  • 1Faculty of Nursing, Federal University of Goias, Goiânia, Goiás, Brazil; Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Sydney, New South Wales, Australia.

Injury
|September 22, 2018
PubMed
Summary
This summary is machine-generated.

Loaner surgical instruments often arrive contaminated and remain soiled after manual cleaning, posing risks to patient safety. Improved reprocessing and instrument design are crucial for effective decontamination.

Keywords:
BiofilmsCleaningImplantsLoaner instrumentationSterilisationSurgical instruments

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Area of Science:

  • Surgical Instrument Reprocessing
  • Biomedical Engineering
  • Infection Control

Background:

  • Reusable surgical instruments (RSIs) acquired through loaner systems are common in orthopaedic surgery.
  • Loaner sets include complex RSIs and single-use implants, posing cleaning challenges.
  • Inadequate cleaning and reprocessing can compromise instrument safety and promote biofilm formation, especially in low-resource settings.

Purpose of the Study:

  • To assess the condition of orthopaedic loaner sets upon hospital arrival.
  • To evaluate the effectiveness of manual reprocessing for complex RSIs.
  • To determine the impact of multiple reprocessing cycles on single-use implants.

Main Methods:

  • Flexible medullary reamers, depth gauges, and screws from Brazilian loaner companies were analyzed.
  • Tests included residual ATP, protein, bacterial contamination, endotoxin, and biofilm detection.
  • Assessment was performed before and after manual cleaning and steam sterilization.

Main Results:

  • Instruments and screws arrived visibly contaminated with blood, ATP, protein, and bacteria.
  • Manual cleaning left visible soil and protein on a significant portion of instruments.
  • Scanning electron microscopy revealed biofilm and soil, including bone fragments, on sterilized instruments and screws.

Conclusions:

  • Contaminated loaner instruments and implants after manual reprocessing highlight insufficient practices.
  • A multidisciplinary approach is needed to improve RSI design for complete decontamination.
  • Enhanced reprocessing protocols and instrument design are essential for surgical patient safety.