A study published in Infection Control & Hospital Epidemiology found that “even brief contact with a contaminated surface can affect the sterility of surgical implants.” CIDRAP has the news.
In addition, the study found that “certain disinfection methods can reduce, but not fully eliminate, contamination.”
The researchers “deliberately exposed 213 polyethylene (PE) implant liners from hip or knee implants to contamination by placing them on the operating room (OR) floor where the surgeon had stood for 10 seconds immediately following orthopedic surgery.” They then divided each implant in half and “swabbed one half for bacteria before applying any antiseptic intervention and swabbed the other half after applying either chlorhexidine gluconate (CHG) and alcohol, povidone and iodine (PI), or ethanol (EtOH) as disinfectants. The control consisted of no disinfection.”
The CHG and PI immersions “reduced the pathogens on the implants better than EtOH or the control group. Median bacterial counts fell from 10 (0 to 60) colony-forming units (CFU) before disinfection to 0 (0 to 20) CFU after, with CHG and PI performing similarly and both significantly reducing bacterial counts better than the control.”
These results underscore that “even brief exposure to nonsterile environments can introduce microbes that are not easily or fully removed from implants, and that, whenever possible, dropped implants should be replaced rather than disinfected.” Immersion in sterile CHG or PI is “preferable to ethanol or no intervention” if an alternative is unavailable, but “patients should be informed of the event and monitored for signs of infection.”
