Glove and instrument changing to prevent bacterial contamination in infected wound debridement and closure procedures: A prospective observational study |
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Authors: | Alexandria M Carroll Kevin G Kim Elliot T Walters Brian K Phillips Brinder Singh Paige K Dekker John S Steinberg Christopher E Attinger Paul J Kim Karen K Evans |
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Institution: | 1. Georgetown University School of Medicine, Washington District of Columbia, USA ; 2. Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington District of Columbia, USA ; 3. MedStar Georgetown University Hospital, Washington District of Columbia, USA ;4.Present address: Orlando Health, Orlando Florida, USA ;5.Present address: Holy Cross Health, Silver Spring Maryland, USA ;6.Present address: Currently with UT Southwestern, Dallas Texas, USA |
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Abstract: | Many surgeons use a single table of instruments for both excisional debridement and coverage/closure of infected wounds. This study investigates the effectiveness of a two‐table set‐up of sterile instruments, in addition to glove exchange, to reduce instrument cross‐contamination during these procedures. This is a prospective, single‐site, institutional review board‐approved observational study of surgical debridements of infected wounds over a 17‐month period. Two separate sterile surgical tables were used for each case: Table A for initial wound debridement (debridement set‐up) and Table B for wound coverage/closure (clean set‐up). Swabs of each table and its respective instruments were taken after debridement but prior to coverage/closure. The primary outcome of interest was bacterial growth at 48 hours. There were 72 surgical cases included in this study. Culture results of Table A demonstrated bacterial growth in 23 of 72 (32%) cases at 48 hours compared with 5of 72 (7%) from Table B (P = .001). These data suggest that there is significant bacterial contamination of surgical instruments used for debridement of infected wounds. Use of a two‐table set‐up reduced instrument cross‐contamination by 78%, suggesting avoidable re‐contamination of the wound. |
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Keywords: | debridement equipment contamination surgical instrument surgical gloves surgical site infection |
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