The spatial distribution of aerosols in high-speed bone burring with external irrigation

It is well-known that the use of high-speed burring devices with irrigation used in bone surgery produces aerosols, and can toss tissue particles into space. The aim of this study was to assess the spatial vertical contamination in the sterile operation field while using a high-speed cutting device at various locations. A fresh porcine knee was resected for 10 min with a high-speed burring device. To determine the spatial contamination distribution bacteria were used as a tracer. In this novel method for detecting environmental contamination droplets of the contaminated irrigation solution were collected on vertically mounted Petri dishes and the number of colony-forming units was counted. Contamination of varying intensity was observed throughout the room. The highest contamination was found perpendicular to the bur rotation axis in a distance 0.5 m from the bur, at a height of 1.4 m. Around this spot, colony-forming units count isotropically drops to less than 100 CFUs at an area of 0.5 m in diameter. The contamination decreases with increasing distance to the bur head and a main direction of contamination was identified. Placing critical sterile objects in the highly contaminated space during and after bone resection procedures should be avoided whenever possible.