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Published on: June 23, 2020

Bacterial contamination of the surgical field during major orthopaedic procedures: is this a cause for concern?

Jan Vanderstappen1, Sylvester Heerwegh2, Jo De Schepper1

  • 1Orthokliniek, Department of Orthopaedic Surgery, VITAZ Hospital, Moerlandstraat 1, Sint-Niklaas, Belgium.

The Journal of Hospital Infection
|May 14, 2026
PubMed
Abstract

Insights

Bacterial contamination of surgical suction tips in orthopaedic surgery is common but does not predict surgical site infections (SSIs). Spinal surgery and patient factors are stronger predictors of SSIs, guiding targeted prevention strategies.

Area of Science:

  • Orthopaedic Surgery
  • Infectious Disease Control
  • Patient Safety

Background:

  • Bacterial contamination of surgical suction tips during orthopaedic surgery may indicate intraoperative microbial exposure.
  • The predictive value of suction tip contamination for surgical site infections (SSIs) remains unclear.

Purpose of the Study:

  • Evaluate the incidence of suction tip contamination in major orthopaedic procedures.
  • Determine the association between suction tip contamination and SSIs.
  • Identify risk factors associated with SSIs in this patient population.

Main Methods:

  • Prospective cohort study of 760 patients undergoing major orthopaedic surgery.
  • Aseptic collection and culturing of suction tip fragments post-procedure.
  • Monitoring for SSIs for at least 90 days and logistic regression analysis.

Main Results:

  • Suction tip contamination occurred in 3.55% of cases, with SSIs in 0.66%; no significant association was found between them.
  • Spinal surgery increased odds of both contamination and SSI.
  • Prolonged operative time, higher BMI, and immunosuppression were associated with increased SSI risk.

Conclusions:

  • Suction tip contamination is frequent but not a reliable predictor of SSIs.
  • Spinal procedures, extended surgery duration, and patient comorbidities are significant SSI predictors.
  • Suction tip cultures have limited clinical utility for predicting SSIs; prevention should address multifactorial risks.
Keywords:
Aspirator tipBacterial contaminationHip arthroplastyKnee arthroplastySpinal surgerySurgical site infection

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