title: Environmental and body contamination through aerosols produced by high-speed cutters in lumbar spine surgery.
abstract: METHODS
  A cadaver study to evaluate contamination in the operating room through the use of a high-speed bone cutter.
  
  
  OBJECTIVE
  To determine the grade of contamination of animate and inanimate objects through an aerosol intraoperatively, produced by a high-speed cutter during lumbar laminectomy.
  
  
  BACKGROUND
  In spinal surgery, high-speed cutters are used that produce an aerosol consisting of a mixture of irrigation solution, blood, and tissue debris. Such aerosols can be contaminated with potential pathogens. The surgical personnel and the environment are therefore exposed to a contamination risk.
  
  
  METHODS
  Laminectomies at three points (L2-L4) were performed on a human cadaver using a high-speed cutting device. The aerosol produced by the irrigation solution was contaminated with Staphylococcus aureus ATCC 12600. To detect the contamination of the environment and of the surgical team, surveillance cultures were used.
  
  
  RESULTS
  By air sampling, staphylococci were detected in the operating room at an extension of 5 by 7 m. The surgical team showed extensive face and body contamination with S. aureus. Despite protection by a barrier drape, similar contamination was observed on both the cadaver's head and the anesthesiologist.
  
  
  CONCLUSIONS
  The use of high-speed cutters in spinal surgery produces an aerosol that can be contaminated with blood-borne pathogens from infected patients. This aerosol is spread over the whole surgical room and contaminates the room and all personnel present. It is therefore critical to ensure that effective infection control measures are performed, not only by the surgeons but by everyone present in the operating room. The room itself must be sufficiently disinfected after such procedures.
authors.affiliation: Department of Orthopaedic Surgery, University of Innsbruck, Austria. michael.nogler@uibk.ac.at
authors.forename: M
authors.initials: M
authors.lastname: Nogler
authors.forename: C
authors.initials: C
authors.lastname: Lass-Flörl
authors.forename: M
authors.initials: M
authors.lastname: Ogon
authors.forename: E
authors.initials: E
authors.lastname: Mayr
authors.forename: C
authors.initials: C
authors.lastname: Bach
authors.forename: C
authors.initials: C
authors.lastname: Wimmer
mesh_terms: D000336:Aerosols / Q000009:adverse effects; D017848:Blood-Borne Pathogens; D002102:Cadaver; D003264:Containment of Biohazards; D004783:Environmental Microbiology; D004866:Equipment Contamination; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008505:Medical Staff, Hospital; D016273:Occupational Exposure / Q000009:adverse effects*; D009873:Operating Rooms; D019637:Orthopedic Procedures / Q000295:instrumentation*; D013211:Staphylococcus aureus / Q000254:growth & development / Q000302:isolation & purification; D013525:Surgical Instruments / Q000382:microbiology*; D013514:Surgical Procedures, Operative
chemical_list: D000336:Aerosols