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Risk of wound and pelvic infection after laparoscopic tubal sterilization: instrument disinfection versus
Abstract:
To determine if disinfection, rather than sterilization, of laparoscopic equipment leads to an increase in the risk of postlaparoscopy infection, the authors analyzed data from a multicenter prospective study conducted by the Centers for Disease Control on the safety of sterilizing operations. From September 1978 through July 1981, 3903 women underwent laparoscopic tubal sterilization procedures in which the equipment was sterilized with ethylene oxide (58%) or disinfected with glutaraldehyde (42%). The overall risk of wound infection in each group was 1.5 per 100 women. The relative risk of wound infection for disinfection versus sterilization of the equipment was 0.5 when adjusted for differences in the two groups. The corresponding relative risk of pelvic infection was 1.2. These results suggest that laparoscopy equipment disinfected with glutaraldehyde is not associated with an increased risk of wound or pelvic infection compared with equipment sterilized with ethylene oxide.
Insights
Disinfection of laparoscopic equipment using glutaraldehyde does not increase infection risk compared to ethylene oxide sterilization. This finding supports the safety of glutaraldehyde disinfection for laparoscopic procedures, reducing post-surgery infection concerns.
Area of Science:
- Medical Microbiology
- Surgical Infection Prevention
- Gynecologic Surgery
Background:
- Laparoscopic procedures require meticulous equipment reprocessing to prevent surgical site infections.
- Sterilization and disinfection are two primary methods for medical device decontamination, each with distinct efficacy profiles.
- Concerns exist regarding the potential for increased infection risk when disinfection, rather than sterilization, is employed for complex surgical instruments.
Purpose of the Study:
- To evaluate whether disinfection of laparoscopic equipment increases the risk of post-laparoscopy infections.
- To compare infection rates associated with glutaraldehyde disinfection versus ethylene oxide sterilization of laparoscopic equipment.
Main Methods:
- Analysis of data from a multicenter prospective study involving 3903 women undergoing laparoscopic tubal sterilization.
- Comparison of infection risks between groups using equipment sterilized with ethylene oxide (58%) and those using equipment disinfected with glutaraldehyde (42%).
- Calculation of relative risks for wound and pelvic infections, adjusted for group differences.
Main Results:
- The overall wound infection rate was 1.5 per 100 women in both sterilization and disinfection groups.
- The adjusted relative risk of wound infection was 0.5 for glutaraldehyde disinfection compared to ethylene oxide sterilization.
- The adjusted relative risk of pelvic infection was 1.2 for glutaraldehyde disinfection compared to ethylene oxide sterilization.
Conclusions:
- Laparoscopic equipment disinfected with glutaraldehyde is not associated with an increased risk of wound infection compared to ethylene oxide sterilization.
- The risk of pelvic infection shows a slight, non-significant increase with glutaraldehyde disinfection.
- Glutaraldehyde disinfection appears to be a safe alternative to ethylene oxide sterilization for laparoscopic equipment, regarding wound infection risk.