title: Tourniquets and exsanguinators: a potential source of infection in the orthopedic operating theater?
abstract: OBJECTIVE
  Fomites are increasingly being recognised as a source of hospital-acquired infection. We have therefore assessed tourniquets and exsanguinators for the presence of bacterial pathogens in 1 elective and 2 trauma orthopedic hospitals.
  
  
  METHODS
  Swabs were taken prior to and after decontaminating these devices with 1 of 3 different cleaning modalities. These were then assessed for colony counts and organisms identified.
  
  
  RESULTS
  Bacteria commonly implicated in surgical site infections such as coagulase-negative staphylococci, Staphylococcus aureus and Proteus spp. were prevalent. We also found a resistant strain of Acinetobacter and Candida. Exsanguinators were the most heavily contaminated devices, and colony counts in the trauma hospitals were up to 400% higher than in the elective hospital. Alcohol- and non-alcohol-based sterile wipes were both highly effective in decontaminating the devices.
  
  
  CONCLUSIONS
  Infectious organisms reside on the tourniquets and exsanguinators presently used in the orthopedic theater. These fomites may possibly be a source of surgical site infection. We have demonstrated a simple and effective means of decontaminating these devices between cases.
authors.affiliation: Cappagh National, Orthopaedic Hospital, Dublin, Ireland.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Brennan
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Walls
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Smyth
authors.forename: Talal
authors.initials: T
authors.lastname: Al Mulla
authors.forename: John M
authors.initials: JM
authors.lastname: O'Byrne
mesh_terms: D001458:Bandages / Q000382:microbiology*; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000382:microbiology*; D004866:Equipment Contamination; D050456:Fomites; D006801:Humans; D017053:Infection Control; D009873:Operating Rooms; D014111:Tourniquets / Q000382:microbiology*