title: Sterility of surgical site marking.
abstract: BACKGROUND
  Over the past decade, wrong-site surgery has been a popular topic of discussion, not only in medical and legal journals but also in the mainstream press. Marking of the surgical site according to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Universal Protocol was implemented at our institution to help reduce the number of wrong-site operations. In this study, we determined whether marking of the site affected the sterility of the surgical field.
  
  
  METHODS
  The study included twenty volunteers. The right forearm was used as the experimental (marked) arm and the left forearm, as the control arm. The experimental forearms were marked with a surgical marker as described by the protocol. Both upper extremities were then sterilized from the antecubital fossa to the phalanges with a 7.5% povidone-iodine scrub followed by the application of a 10% povidone-iodine paint. Swabs were used to obtain samples from the experimental and control arms as well as from the marker and were sent for microbiological culture and analysis.
  
  
  RESULTS
  No growth was seen in the cultures of the swabs used on the experimental or control arms or on the marking pens.
  
  
  CONCLUSIONS
  Preoperative marking of surgical sites in accordance with the JCAHO Universal Protocol did not affect the sterility of the surgical field, a finding that provides support for the safety of surgical site marking.
authors.affiliation: Department of Orthopaedics, West Virginia University, P.O. Box 9196, Health Sciences Center, Morgantown, WV 26506-9196, USA. wvubonehead@yahoo.com
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Cronen
authors.forename: Vytautas
authors.initials: V
authors.lastname: Ringus
authors.forename: Gavin
authors.initials: G
authors.lastname: Sigle
authors.forename: Jaiyoung
authors.initials: J
authors.lastname: Ryu
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D000985:Antisepsis / Q000379:methods; D004396:Coloring Agents / Q000008:administration & dosage*; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D010355:Patient Identification Systems; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011300:Preoperative Care; D017751:Safety Management; D013530:Surgical Wound Infection / Q000209:etiology
chemical_list: D000891:Anti-Infective Agents, Local; D004396:Coloring Agents; D011206:Povidone-Iodine