Chemical Disinfection of an Accidentally Contaminated and Irreplaceable Inorganic Element During Orthopaedic Surgery...

During surgical procedures, the accidental contamination of a critical instrument or implant can jeopardize the entire operation. Resterilizing the item is not always feasible and can be time-consuming. Since extending the duration of the surgery heightens the risk of postoperative complications, it is essential to balance this risk with the risk of infection from contamination. Currently, there is no simple, safe, and quickly available method to address this issue. This study explored the efficacy of using chemical disinfection to deal with this problem.

In part 1 of the study, 3 types of discs (cobalt-chromium, titanium, and polyethylene) were contaminated with Staphylococcus epidermidis, disinfected with use of 3 different procedures (2% chlorhexidine in 70% isopropanol alcohol, 0.9% povidone-iodine in 46% isopropanol alcohol, or 70% ethanol), and analyzed for remaining bacteria. A control group without disinfection was included. In part 2, the discs were dropped on the floor of an operating room, left on the floor for 30 seconds, and then collected before undergoing the same procedure as in part 1.

In part 1, all 3 alcohol-based disinfection procedures showed a high efficacy, as there was no growth found on any of the discs. These results were highly significant compared with those found for the control group (p < 0.01 for all). In the control group, polyethylene had the highest mean level of contamination (157.3 colony-forming units [CFUs]) and titanium had the lowest (58.4 CFUs). Part 2 confirmed the effectiveness of alcohol-based disinfection, with no growth observed in the test cultures. In the control group, polyethylene seemed to be the most prone to contamination. However, the level of contamination was low for all materials (0 to 8 CFUs per disc).

In the event of accidental contamination of an essential element or implant during a surgical procedure with no possibility of replacing the element, 2 minutes of disinfection in an alcohol-based solution seems to be a safe, simple, and quick option.

In the event of accidental contamination of an irreplaceable inorganic element during orthopaedic surgery, we recommend soaking the element in an alcohol-based disinfectant for 2 minutes and rinsing it with saline solution.