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High bacterial contamination rate of electrocautery tips during total hip and knee arthroplasty

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Abstract

Purpose

The aim of the study was to quantify the bacterial contamination rate of electrocautery tips during primary total joint replacement (TJR), as well as during aseptic and septic revision TJR.

Methods

A total of 150 electrocautery tips were collected between April and July 2017. TJR surgeries were divided into three groups: (1) primary, (2) aseptic and (3) septic revisions. In each group, a total of 50 electrocautery tips were collected. A monopolar electrocautery with a reusable stainless-steel blade tip was used in all cases. The rate of bacterial contamination was determined for all groups. Correlation of exposure time and type of surgery was analyzed.

Results

The overall bacterial contamination rate was 14.7% (95% CI 9.4 to 21.4%). The highest contamination rate occurred in the septic revision group (30.0%; 95% CI 17.9 to 44.6%), followed by the primary cases group (10.0%; 95% CI 3.3 to 21.8%) and the aseptic revision group (4.0%; 95% CI 0.5 to 13.7%). Exposure time did not affect the bacterial contamination rate. In 12 out of 15 (80%) contaminations identified in the septic group, we found the same causative microorganism of the prosthetic joint infection on the electrocautery tip.

Conclusions

The bacterial contamination of the electrocautery tips is relatively high, especially during septic hip revision arthroplasty. Electrocautery tips should be changed after debridement of infected tissue.

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References

  1. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR (1999) Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 20(4):250–278; quiz 279-280. https://doi.org/10.1086/501620

    Article  CAS  PubMed  Google Scholar 

  2. Davis N, Curry A, Gambhir AK, Panigrahi H, Walker CR, Wilkins EG, Worsley MA, Kay PR (1999) Intraoperative bacterial contamination in operations for joint replacement. J Bone Joint Surg Br 81(5):886–889

    Article  CAS  PubMed  Google Scholar 

  3. Falconer TM, Baba M, Kruse LM, Dorrestijn O, Donaldson MJ, Smith MM, Figtree MC, Hudson BJ, Cass B, Young AA (2016) Contamination of the surgical field with Propionibacterium acnes in primary shoulder arthroplasty. J Bone Joint Surg Am 98(20):1722–1728. https://doi.org/10.2106/JBJS.15.01133

    Article  PubMed  Google Scholar 

  4. Ottesen C, Skovby A, Troelsen A, Specht C, Friis-Moller A, Husted H (2014) No need to change the skin knife in modern arthroplasty surgery. Arch Orthop Trauma Surg 134(8):1163–1166. https://doi.org/10.1007/s00402-014-1974-z

    Article  CAS  PubMed  Google Scholar 

  5. Quint U, Benen T (2016) Possible instrument contamination in the operating room during implantation of knee and hip arthroplasty. Z Orthop Unfall 154(2):157–162. https://doi.org/10.1055/s-0035-1568194

    Article  CAS  PubMed  Google Scholar 

  6. Schweitzer D, Klaber I, Fischman D, Wozniak A, Botello E, Amenabar PP (2015) Surgical light handles: a source of contamination in the surgical field. Acta Orthop Traumatol Turc 49(4):421–425. https://doi.org/10.3944/AOTT.2015.14.0401

    PubMed  Google Scholar 

  7. Parvizi J, Gehrke T, Chen AF (2013) Proceedings of the International Consensus on Periprosthetic Joint Infection. Bone Joint J 95-B(11):1450–1452. https://doi.org/10.1302/0301-620X.95B11.33135

    Article  CAS  PubMed  Google Scholar 

  8. Shahi A, Chen AF, McKenna PB, Roberts AL, Manrique J, Belden KA, Austin MS (2015) Bacterial contamination in tips of electrocautery devices during total hip arthroplasty. J Arthroplast 30(8):1410–1413. https://doi.org/10.1016/j.arth.2015.03.011

    Article  Google Scholar 

  9. Leary JT, Werger MM, Broach WH, Shaw LN, Santoni BG, Bernasek TL, Lyons ST (2017) Complete eradication of biofilm from orthopedic materials. J Arthroplast 32(8):2513–2518. https://doi.org/10.1016/j.arth.2017.03.050

    Article  Google Scholar 

  10. Figa R, Muneton D, Gomez L, Matamala A, Lung M, Cuchi E, Corona PS (2017) Periprosthetic joint infection by Propionibacterium acnes: clinical differences between monomicrobial versus polymicrobial infection. Anaerobe 44:143–149. https://doi.org/10.1016/j.anaerobe.2017.03.008

    Article  PubMed  Google Scholar 

  11. Nodzo SR, Westrich GH, Henry MW, Miller AO (2016) Clinical analysis of Propionibacterium acnes infection after total knee arthroplasty. J Arthroplast 31(9):1986–1989. https://doi.org/10.1016/j.arth.2016.02.025

    Article  Google Scholar 

  12. Trampuz A, Zimmerli W (2008) Diagnosis and treatment of implant-associated septic arthritis and osteomyelitis. Curr Infect Dis Rep 10(5):394–403

    Article  PubMed  Google Scholar 

  13. Zimmerli W, Trampuz A, Ochsner PE (2004) Prosthetic-joint infections. N Engl J Med 351(16):1645–1654. https://doi.org/10.1056/NEJMra040181

    Article  CAS  PubMed  Google Scholar 

  14. Mayer RR, Bederman SS, Colin VM, Berger MM, Cesario TC, Schwarzkopf R (2016) Risk of contamination in assembled vs disassembled instruments in hip arthroplasty surgery. J Arthroplast 31(8):1746–1749. https://doi.org/10.1016/j.arth.2016.02.004

    Article  Google Scholar 

  15. prevention Cfdca (2017) Guideline for disinfection and sterilization in healthcare facilities. https://http://www.cdc.gov/infectioncontrol/guidelines/disinfection/sterilization/steam.html

  16. Frowen P, O’Donnell M, Burrow JG (2010) Neale’s disorders of the foot, 8th edn. Churchill Livingstone

  17. Bennett RG, Kraffert CA (1990) Bacterial transference during electrodesiccation and electrocoagulation. Arch Dermatol 126(6):751–755

    Article  CAS  PubMed  Google Scholar 

  18. Shaw DH, Kalkwarf KL, Krejci RF, Edison AR (1988) Self-sterilization of the electrosurgery electrode. Oral Surg Oral Med Oral Pathol 66(3):290–292

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors acknowledge the support of Dr. S. Schubert and Dr. A. Büter. The work of the study coordinator, Mrs. Gabriele Paprotzki; of Carola Hogrefe (study nurse); and of Dr. Silke Lange (statistician) is also appreciated.

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Correspondence to Mustafa Citak.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was performed after obtaining approval from the institutional review board. The PV number is “PV5476.”

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Abdelaziz, H., Zahar, A., Lausmann, C. et al. High bacterial contamination rate of electrocautery tips during total hip and knee arthroplasty. International Orthopaedics (SICOT) 42, 755–760 (2018). https://doi.org/10.1007/s00264-018-3822-1

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