Updates on Evidence-Based Practices to Reduce Preoperative and Intraoperative Contamination of Implants in Spine Surgery: A Narrative Review
The current communication seeks to provide an updated narrative review on latest methods of reducing implant contaminations used during spine surgery. Recent literature review has shown that both preoperative reprocessing and intraoperative handling of implants seem to contaminate implants. In brief...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
The Japanese Society for Spine Surgery and Related Research
2020-04-01
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| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/4/2/4_2019-0038/_pdf/-char/en |
| _version_ | 1811218226665750528 |
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| author | Aakash Agarwal Boren Lin Hossein Elgafy Vijay Goel Chris Karas Christian Schultz Neel Anand Steve Garfin Jeffrey Wang Anand Agarwal |
| author_facet | Aakash Agarwal Boren Lin Hossein Elgafy Vijay Goel Chris Karas Christian Schultz Neel Anand Steve Garfin Jeffrey Wang Anand Agarwal |
| author_sort | Aakash Agarwal |
| collection | DOAJ |
| description | The current communication seeks to provide an updated narrative review on latest methods of reducing implant contaminations used during spine surgery. Recent literature review has shown that both preoperative reprocessing and intraoperative handling of implants seem to contaminate implants. In brief, during preoperative phase, the implants undergo repeated bulk cleaning with dirty instruments from the OR, leading to residue buildup at the interfaces and possibly on the surfaces too. This, due to its concealed nature, remains unnoticed by the SPD (sterile processing department) or other hospital staff. Nevertheless, these can be avoided by using individually prepackaged presterilized implants. In the intraoperative phase, the implants (in the sterile field) are directly touched by the scrub tech with soiled (assisting the surgeon dispose the tissues from the instruments in use) gloves for loading onto an insertion device. It is then kept exposed on the working table (either separately or next to the used instruments as the pedicles hole are being prepared). Latest investigation has shown that by the time it is implanted in the patient, it can harbor up to 10e7 bacterial colony-forming units. The same implants were devoid of such colony-forming units, when sheathed by an impermeable sterile sheath around the sterile implant. |
| first_indexed | 2024-04-12T07:07:32Z |
| format | Article |
| id | doaj.art-b68b6d0ad91c46aebb45041f40e7174a |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-04-12T07:07:32Z |
| publishDate | 2020-04-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-b68b6d0ad91c46aebb45041f40e7174a2022-12-22T03:42:45ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2020-04-014211111610.22603/ssrr.2019-00382019-0038Updates on Evidence-Based Practices to Reduce Preoperative and Intraoperative Contamination of Implants in Spine Surgery: A Narrative ReviewAakash Agarwal0Boren Lin1Hossein Elgafy2Vijay Goel3Chris Karas4Christian Schultz5Neel Anand6Steve Garfin7Jeffrey Wang8Anand Agarwal9Department of Biology, Bioengineering and Orthopaedics Surgery, University of ToledoDepartment of Biology, Bioengineering and Orthopaedics Surgery, University of ToledoDepartment of Biology, Bioengineering and Orthopaedics Surgery, University of ToledoDepartment of Biology, Bioengineering and Orthopaedics Surgery, University of ToledoBone and Joint Center, OhioHealth Grant MedicalDepartment of Biology, Bioengineering and Orthopaedics Surgery, University of ToledoSpine Center, Cedars Sinai Medical CenterDepartment of Orthopaedics, University of CaliforniaDepartment of Orthopaedics, University of Southern CaliforniaDepartment of Biology, Bioengineering and Orthopaedics Surgery, University of ToledoThe current communication seeks to provide an updated narrative review on latest methods of reducing implant contaminations used during spine surgery. Recent literature review has shown that both preoperative reprocessing and intraoperative handling of implants seem to contaminate implants. In brief, during preoperative phase, the implants undergo repeated bulk cleaning with dirty instruments from the OR, leading to residue buildup at the interfaces and possibly on the surfaces too. This, due to its concealed nature, remains unnoticed by the SPD (sterile processing department) or other hospital staff. Nevertheless, these can be avoided by using individually prepackaged presterilized implants. In the intraoperative phase, the implants (in the sterile field) are directly touched by the scrub tech with soiled (assisting the surgeon dispose the tissues from the instruments in use) gloves for loading onto an insertion device. It is then kept exposed on the working table (either separately or next to the used instruments as the pedicles hole are being prepared). Latest investigation has shown that by the time it is implanted in the patient, it can harbor up to 10e7 bacterial colony-forming units. The same implants were devoid of such colony-forming units, when sheathed by an impermeable sterile sheath around the sterile implant.https://www.jstage.jst.go.jp/article/ssrr/4/2/4_2019-0038/_pdf/-char/ensurgical site infectioncontaminationbioburdenorthopedic implantsasepsispedicle screwsbiofilmreprocessingintraoperative handlingimplant prophylaxisoccult infection |
| spellingShingle | Aakash Agarwal Boren Lin Hossein Elgafy Vijay Goel Chris Karas Christian Schultz Neel Anand Steve Garfin Jeffrey Wang Anand Agarwal Updates on Evidence-Based Practices to Reduce Preoperative and Intraoperative Contamination of Implants in Spine Surgery: A Narrative Review Spine Surgery and Related Research surgical site infection contamination bioburden orthopedic implants asepsis pedicle screws biofilm reprocessing intraoperative handling implant prophylaxis occult infection |
| title | Updates on Evidence-Based Practices to Reduce Preoperative and Intraoperative Contamination of Implants in Spine Surgery: A Narrative Review |
| title_full | Updates on Evidence-Based Practices to Reduce Preoperative and Intraoperative Contamination of Implants in Spine Surgery: A Narrative Review |
| title_fullStr | Updates on Evidence-Based Practices to Reduce Preoperative and Intraoperative Contamination of Implants in Spine Surgery: A Narrative Review |
| title_full_unstemmed | Updates on Evidence-Based Practices to Reduce Preoperative and Intraoperative Contamination of Implants in Spine Surgery: A Narrative Review |
| title_short | Updates on Evidence-Based Practices to Reduce Preoperative and Intraoperative Contamination of Implants in Spine Surgery: A Narrative Review |
| title_sort | updates on evidence based practices to reduce preoperative and intraoperative contamination of implants in spine surgery a narrative review |
| topic | surgical site infection contamination bioburden orthopedic implants asepsis pedicle screws biofilm reprocessing intraoperative handling implant prophylaxis occult infection |
| url | https://www.jstage.jst.go.jp/article/ssrr/4/2/4_2019-0038/_pdf/-char/en |
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