Chronological changes in the rate of surgical field contamination in the shoulder joint

IF 1.5 4区 医学 Q3 ORTHOPEDICS
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Abstract

Background

In shoulder surgery, low-virulence bacteria such as Cutibacterium acnes and coagulase-negative staphylococci can cause postoperative infection. However, the degree of sterility during surgery after disinfection is not known, and the efficacy of double skin preparation for such bacteria is unclear. This study aimed to evaluate chronological changes in the surgical field contamination rate in the shoulder joint and to compare single and double skin preparation.

Methods

In total, 126 shoulders in 121 patients undergoing shoulder surgery (64 men, 62 women; mean age 64 years) were enrolled. Patients were divided into two groups: single skin preparation, where the site was painted with 10% povidone iodine, and double skin preparation, where the site was treated with 1% chlorhexidine gluconate/83% isopropyl alcohol and painted 10% povidone iodine. Swab samples from the axillary and proximal areas in the surgical field were collected chronologically before starting surgery and at 30, 60, and 120 min after starting surgery (MAS). The contamination rate of each sample was compared and detected species were evaluated.

Results

The contamination rate for the axillary area was 48.4%, 85.9%, 95.3%, and 97.1% in the single-preparation group and 32.3%, 72.6%, 87.1%, and 91.2% in the double-preparation group before starting surgery and 30, 60, and 120 MAS, respectively, and that the proximal area was 12.5%, 26.6%, 29.7%, and 35.3% in the single-preparation group and 16.1%, 19.4%, 27.4%, and 38.2% in the double-preparation group, respectively. Significant differences were not seen between the groups by area or time point. Most detected species were Cutibacterium acnes and coagulase-negative staphylococci.

Conclusions

The incidence of surgical field contamination in shoulder joint was high from immediately after starting surgery. In the axillary area, the contamination rates exceeded 70% from 30 MAS in both groups. Measures against infection should be instituted considering these findings when performing shoulder surgery.

肩关节手术野污染率的时间变化。
背景:在肩部手术中,低毒力细菌如痤疮杆菌和凝固酶阴性葡萄球菌可引起术后感染。然而,消毒后手术期间的无菌程度尚不清楚,双皮制剂对此类细菌的疗效也不清楚。本研究旨在评估肩关节手术现场污染率的时间变化,并比较单层和双层皮肤的准备情况。方法:共有121名接受肩部手术的患者(64名男性,62名女性;平均年龄64岁)中的126名肩部被纳入研究。患者被分为两组:单次皮肤制剂,用10%聚维酮碘涂抹,双次皮肤制剂用1%葡萄糖酸氯己定/83%异丙醇治疗,用10%聚维酮碘涂。在开始手术前以及在开始手术后30、60和120分钟(MAS)按时间顺序收集手术区腋窝和近端区域的拭子样本。对每个样品的污染率进行比较,并对检测到的物种进行评估。结果:术前30、60和120 MAS,单制剂组腋窝污染率分别为48.4%、85.9%、95.3%和97.1%,双制剂组分别为32.3%、72.6%、87.1%和91.2%,双制剂组分别为38.2%。两组之间在区域或时间点上没有发现显著差异。检出最多的是痤疮杆菌和凝固酶阴性葡萄球菌。结论:肩关节手术区污染的发生率从术后即刻开始就很高。在腋窝区域,两组的污染率均从30 MAS超过70%。在进行肩部手术时,应考虑到这些发现,制定预防感染的措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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