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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Marking Pen Bacterial Contamination During Shoulder Surgery.

Kevin Magone1,2, Jacob Ristow2, Kyle Root3,4

  • 1CHI Saint Joseph Medical Group - Orthopedic Associates, CHI Saint Joseph Health, London, Kentucky, USA.

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PubMed
Summary

Sterile surgical marking pens used after skin preparation showed no increased bacterial contamination compared to those used before. This suggests current practices are safe, but pens should still be discarded after use.

Keywords:
Propionibacterium acnesbacterial contaminationinfectionshouldershoulder surgeryskin marking pen

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Area of Science:

  • Surgical Safety
  • Microbiology
  • Infection Control

Background:

  • Surgical equipment can be a source of bacterial contamination.
  • Understanding contamination sources is crucial for preventing surgical site infections.

Purpose of the Study:

  • To compare bacterial contamination rates of sterile surgical marking pens used before and after skin preparation for shoulder surgery.
  • Hypothesized no significant difference in culture-positive rates between pens used pre- and post-skin prep.

Main Methods:

  • Prospective study of 43 patients undergoing elective shoulder surgery.
  • Collected samples from pens used after skin prep (study pens) and before (positive controls).
  • Negative controls (new pens) and statistical analysis (Fisher exact test) were used.

Main Results:

  • One study pen (2.3%) and two positive control pens (4.7%) showed bacterial growth.
  • No negative control pens were contaminated (0%).
  • No statistically significant difference in culture-positive rates was found between groups (P ≥ .999).

Conclusions:

  • Sterile surgical marking pens did not show increased contamination when used after skin preparation.
  • Results support the safety of current marking pen usage in relation to bacterial contamination.
  • Recommend discarding pens after skin contact to maintain sterile field integrity.