Surgical light handles: a source of contamination in the surgical field

Year 2015, Volume: 49 Issue: 4, 421 - 425, 19.08.2015

Daniel Schweitzer İaniv Klaber Daniel Fischman Aniela Wozniak Pedro Pablo Amenábar Eduardo Botello

Abstract

Objective: Total hip arthroplasty (THA) is a common and generally safe procedure; however, among the most devastating complications associated with THA is periprosthetic infection (PPI). The origin of bacteria causing PPI is not completely understood. The aims of the present study were to identify bacterial contamination of light handles with up-to-date culture methods and to determine the safety in using these handles in hip arthroplasty surgery.
Methods: A total of 36 surgical handles randomly selected from primary hip arthroplasty procedures were screened for bacterial contamination using 2 different culture methods, including 1 with high sensitivity. Two types of controls were used. Cultures were kept for up to 10 days, and retrieved bacteria were identified.
Results: Fifty percent of the light handles yielded positive cultures, demonstrating a bacterial presence on surgical light handles during hip arthroplasty. The most frequently identified bacteria were Staphylococcus epidermidis and Staphylococcus aureus.
Conclusion: A large number of positive bacterial cultures were found in manipulated light handles during hip replacement surgery, representing a potential contamination source that could eventually lead to infection in hip arthroplasty.

 

DOI: 10.3944/AOTT.2015.14.0401

Keywords

Adverse effects; arthroplasty; bacterial diagnosis; bacteria isolation; bacterial infection; bacteria purification; hip; knee; microbiology; replacement; surgical field contamination; surgical light handles.

References

• Parveen S, Kaur S, David SA, Kenney JL, McCormick WM, Gupta RK. Evaluation of growth based rapid mi- crobiological methods for sterility testing of vaccines and other biological products. Vaccine 2011;29:8012–23.
• Tande AJ, Patel R. Prosthetic joint infection. Clin Micro- biol Rev 2014;27:302–45.
• Whyte W, Hodgson R, Tinkler J. The importance of air- borne bacterial contamination of wounds. J Hosp Infect 1982;3:123–35.
• Davis N, Curry A, Gambhir AK, Panigrahi H, Walker CR, Wilkins EG, et al. Intraoperative bacterial contamination in operations for joint replacement. J Bone Joint Surg Br 1999;81:886–9.
• Hussein JR, Villar RN, Gray AJ, Farrington M. Use of light handles in the laminar flow operating theatre--is it a cause of bacterial concern? Ann R Coll Surg Engl 2001;83:353–4.
• Lee YK, Biau DJ, Yoon BH, Kim TY, Ha YC, Koo KH. Learning curve of acetabular cup positioning in total hip arthroplasty using a cumulative summation test for learn- ing curve (LC-CUSUM). J Arthroplasty 2014;29:586– 9.
• Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Eco- nomic burden of periprosthetic joint infection in the Unit- ed States. J Arthroplasty 2012;27(8 Suppl):61-5.e1.