title: Quantification of incidental needle and suture contamination during strabismus surgery.
abstract: OBJECTIVE
  To quantify the level of bacterial contamination of needles and sutures immediately after use in strabismus surgery.
  
  
  METHODS
  Strabismus surgery was performed on 56 eyes from 31 pediatric strabismus surgical cases. Preoperative site preparation included instillation of 5% povidone-iodine in the conjunctival fornices in all cases. A total of 124 needles and 127 sutures were cultured immediately after final scleral passage.
  
  
  RESULTS
  Seventeen of the 31 cases (54.8%) produced at least one positive specimen. Nineteen per cent of the needles and 25.2% of the sutures were culture positive. The bulk of positive specimens (96.7% of needles, 91.3% of sutures) produced 3 or less colony forming units, corresponding to 7 or less total viable organisms per needle or sutures in accordance with the dilution scheme. Coagulase-negative staphylococci overwhelmingly predominated.
  
  
  CONCLUSIONS
  Needles and sutures used in strabismus surgery can become contaminated during surgery despite preoperative povidone-iodine preparation. The number of viable bacterial contaminants is usually below the level known to consistently produce experimental endophthalmitis. However, a few needles and sutures carried a high contaminant load, suggesting the possibility that contaminated needles and sutures could potentially cause postoperative intraocular infection.
authors.affiliation: Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Carothers
authors.forename: David K
authors.initials: DK
authors.lastname: Coats
authors.forename: Kathryn M B
authors.initials: KM
authors.lastname: McCreery
authors.forename: Susan N
authors.initials: SN
authors.lastname: Rossman
authors.forename: Patricia
authors.initials: P
authors.lastname: Wilson
authors.forename: Tzu G
authors.initials: TG
authors.lastname: Wu
authors.forename: Evelyn A
authors.initials: EA
authors.lastname: Paysse
mesh_terms: D000293:Adolescent; D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D009877:Endophthalmitis / Q000382:microbiology / Q000517:prevention & control; D004866:Equipment Contamination; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009339:Needles / Q000382:microbiology*; D013285:Strabismus / Q000601:surgery*; D013537:Sutures / Q000382:microbiology*