The extent of environmental and body contamination through aerosols by hydro-surgical debridement in the lumbar spine

Arch Orthop Trauma Surg. 2017 Jun;137(6):743-747. doi: 10.1007/s00402-017-2668-0. Epub 2017 Mar 20.

Abstract

Introduction: Surgical site infections occur in 1-6% of spinal surgeries. Effective treatment includes early diagnosis, parenteral antibiotics and early surgical debridement of the wound surface.

Materials and methods: On a human cadaver, we executed a complete hydro-surgery debridement including a full surgical setup such as draping. The irrigation fluid was artificially contaminated with Staphylococcus aureus (ATCC 6538). Surveillance cultures were used to detect environmental and body contamination of the surgical team.

Results: For both test setups, environmental contamination was observed in an area of 6 × 8 m. Both test setups caused contamination of all personnel present during the procedure and of the whole operating theatre. However, the concentration of contamination for the surgical staff and the environment was lower when an additional disposable draping device was used.

Conclusions: The study showed that during hydro-surgery debridement, contaminated aerosols spread over the whole surgical room and contaminate the theatre and all personnel.

Keywords: Contamination operating room; Hydro-surgery device; Infection; Spine; Surgical debridement.

MeSH terms

  • Aerosols / adverse effects*
  • Cadaver
  • Containment of Biohazards / adverse effects*
  • Debridement / adverse effects*
  • Environmental Microbiology
  • Equipment Contamination
  • Humans
  • Lumbar Vertebrae / surgery
  • Neurosurgical Procedures / adverse effects*
  • Occupational Exposure
  • Operating Rooms
  • Risk Factors
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / etiology
  • Staphylococcus aureus / isolation & purification*
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / etiology

Substances

  • Aerosols