title: Compressed-air power tools in orthopaedic surgery: exhaust air is a potential source of contamination.
abstract: OBJECTIVE
  To determine if the exhaust from surgical compressed-air power tools contains bacteria and if the exhaust leads to contamination of sterile surfaces.
  
  
  METHODS
  Bacteriologic study of orthopaedic power tools.
  
  
  METHODS
  Level I trauma center operative theater.
  
  
  METHODS
  None.
  
  
  METHODS
  Part I. Exhaust from two sterile compact air drills was sampled directly at the exhaust port. Part II. Exhaust from the drills was directed at sterile agar plates from varying distances. The agar plates represented sterile surfaces within the operative field. Part III. Control cultures. A battery-powered drill was operated over open agar plates in similar fashion as the compressed-air drills. Agar plates left open in the operative theater served as controls to rule out atmospheric contamination. Random cultures were taken from agar plates, gloves, drills, and hoses.
  
  
  METHODS
  Incidence of positive cultures.
  
  
  RESULTS
  In Part I, all filters from both compressed-air drill exhausts were culture negative ( = 0.008). In Part II, the incidence of positive cultures for air drills number one and number two was 73% and 82%, respectively. The most commonly encountered organisms were, coagulase-negative Staphylococcus, and Micrococcus species. All control cultures from agar plates, battery-powered drill, gloves, and hoses were negative ( < 0.01).
  
  
  CONCLUSIONS
  Exhaust from compressed-air power tools in orthopaedic surgery may contribute to the dissemination of bacteria onto the surgical field. We do not recommend the use of compressed-air power tools that do not have a contained exhaust.
authors.affiliation: University of California San Francisco, Fresno Medical Education Program, Fresno, California 93702, USA. eversosaggy@cs.com
authors.forename: H C
authors.initials: HC
authors.lastname: Sagi
authors.forename: Thomas
authors.initials: T
authors.lastname: DiPasquale
authors.forename: Roy
authors.initials: R
authors.lastname: Sanders
authors.forename: Dolfi
authors.initials: D
authors.lastname: Herscovici
mesh_terms: D000391:Air Microbiology; D000395:Air Pollutants, Occupational; D001419:Bacteria / Q000302:isolation & purification; D004866:Equipment Contamination; D006801:Humans; D009873:Operating Rooms; D009983:Orthopedic Equipment / Q000382:microbiology*; D019637:Orthopedic Procedures; D011312:Pressure
chemical_list: D000395:Air Pollutants, Occupational