Medical device SALs and surgical site infections: a mathematical model

Biomed Instrum Technol. 2012 May-Jun;46(3):230-7. doi: 10.2345/0899-8205-46.3.230.

Abstract

It is commonly accepted that terminally sterilized healthcare products are rarely the source of a hospital-acquired infection (HAI). The vast majority of HAIs arise from human-borne contamination from the workforce, the clinical environment, less-than-aseptic handling techniques, and the patients themselves. Nonetheless, the requirement for a maximal sterility assurance level (SAL) of a terminally sterilized product has remained at 10(-6), which is the probability of one in one million that a single viable microorganism will be on a product after sterilization. This paper presents a probabilistic model that predicts choosing an SAL greater than 10(-6) (e.g. 10(-5) or 10(-4), and in some examples even 10(-3) or 10(-2)) does not have a statistically significant impact on the incidence of surgical site infections (SSIs). The use of a greater SAL might allow new, potentially life-saving products that cannot withstand sterilization to achieve a 10(-6) SAL to be terminally sterilized instead of being aseptically manufactured.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Infections / epidemiology*
  • Bacterial Infections / prevention & control*
  • Computer Simulation
  • Cross Infection / epidemiology*
  • Cross Infection / prevention & control*
  • Equipment and Supplies / microbiology*
  • Humans
  • Models, Statistical
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Sterilization / statistics & numerical data*
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / prevention & control
  • United States / epidemiology