Pilot study: Internally cooled orthopedic drills - standard sterilization is not enough?

Area of Science:

• Medical Devices
• Sterilization Science
• Orthopedic Surgery

Background:

• Bone drilling generates heat, potentially causing thermal osteonecrosis.
• Internally cooled bone drills reduce heat but may retain bacteria in lumens.
• Standard sterilization protocols might be inadequate for these novel drills.

Purpose of the Study:

• To evaluate the effectiveness of autoclaving for internally cooled, open-type bone drills.
• To determine optimal sterilization parameters for these medical devices.
• To provide evidence-based recommendations for sterilizing lumened bone drills.

Main Methods:

• Internally cooled bone drills were artificially contaminated with various bacteria.
• Drills were subjected to autoclaving at 132°C and 2.6 bar for 15, 20, and 30 minutes.
• Post-sterilization bacterial presence was assessed to determine effectiveness.

Main Results:

• A 15-minute sterilization cycle showed a 93.75% sterility rate, with one drill remaining contaminated.
• Extended autoclave cycles of 20 and 30 minutes achieved 100% sterility for all tested drills.
• No bacterial contamination was detected after 20 or 30 minutes of autoclaving.

Conclusions:

• Standard autoclave times may not guarantee sterility for internally cooled bone drills.
• An extended sterilization time of at least 20 minutes is minimally recommended.
• Ensuring complete sterility is crucial for preventing surgical site infections and complications.