Effectiveness of FDA-cleared Wound Cleansers for Disinfection of Surgical Surfaces in Resource Limited Environments

Service members experience unique circumstances when providing medical care in austere environments. Some challenges include supply shortages and the need to perform surgery in extreme temperatures. As such, methods for the sanitization of medical tools are sought and efficacy of existing materiel sourced to austere medical facilities should be examined for this purpose. This study tested the efficacy of commercially available, FDA-approved wound cleansers for alternative use as a potential sanitizer of stainless-steel medical devices and instruments found at improvised medical facilities.

Escherichia coli and Staphylococcus aureus cultures were inoculated onto sterile stainless-steel carriers. After cleanser treatment, samples were held for 2 h, 24 h, or 7 days to represent different turn-around times between uses at ambient (25 °C), cold (-20 °C) and hot (50 °C) temperatures. Additional ex vivo challenges were performed using slurry harvested from porcine cecum. Colony-forming units and log reduction were calculated. Significance was determined using one-way ANOVA and multiple comparisons between treatment groups were calculated using Tukey's multiple comparison test.

All wound cleansers demonstrated statistically significant bactericidal activity against lab bacteria and ex vivo cecal slurry. E. coli and S. aureus resulted in approximately a 5-6 log reduction on average, resulting in no growth after treatment for all cleaners at 2  and 24 h. Similarly, 7-day post exposure results in a 6-log reduction after treatment for all groups at 25 °C and -25 °C. While treatment of ex vivo samples did not result in total kill, significant reductions in bacterial load were observed in all groups.

Wound cleansers cleared for use in surgical settings demonstrated antimicrobial effects against bacteria deposited on metal surfaces. These cleansers decreased bacterial viability when challenged against extreme temperatures and few bacteria were harvested from treated surfaces even after 7 days. FDA-approved wound cleaners show promise as a potential sanitizer in resource limited environments.