Glove and instrument changing to prevent bacterial contamination in infected wound debridement and closure procedures: A prospective observational study

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
JournalInternational Wound Journal
DOIs
StateAccepted/In press - 2021

Keywords

  • debridement
  • equipment contamination
  • surgical gloves
  • surgical instrument
  • surgical site infection

ASJC Scopus subject areas

  • Surgery
  • Dermatology

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