Risk of bacterial colonization by torniquet during arthroscopy of the knee joint

The following study investigated the risk of transmission or spread of potentially pathogenic bacteria via surgical gloves and/or with an elastic bandage to achieve a bloodless surgical site during arthroscopy.

This was a single-center, prospective study performed at a level-1 trauma center. The included patients were between 18 and 65 years of age and underwent arthroscopy of the knee joint. Before arthroscopy, two skin swabs (one before and one after wrapping the leg with an elastic bandage) were taken for further microbiological analysis. In addition, the thumb and index finger of the right glove of the surgeon's gloves and the part of the bandage covering the knee joint was kept for microbiological examination.

208 samples from 52 patients were included. No patient had a surgical site infection (SSI) during the follow-up period of at least 12 months. The evaluation of the microbiological findings detected contamination of the elastic wrapping material in 83% (43/52) of the cases, primarily with Bacillus spp. The gloves showed bacterial contamination in only two cases; a transfer to the patient's skin was not be detected. Overall, there was no evidence of contamination from the elastic bandage or the gloves to the skin or from the skin to the wrapping material during the surgical procedure.

Preoperative skin antisepsis is mandatory due to the risk of SSI caused by skin flora. However, in a population without a history of joint infection, the current preoperative standards for skin antisepsis seem to be sufficient to minimize SSIs during knee arthroscopy. A glove change after elastic wrapping is not necessary.