title: The effect of surgical preparation technique on the bacterial load of surgical needles and suture material used during strabismus surgery.
abstract: OBJECTIVE
  To investigate the effectiveness of 3 surgical preparation techniques in decreasing bacterial contamination of needles and suture material during strabismus surgery.
  
  
  METHODS
  Consecutive patients requiring 2-muscle strabismus surgery were randomized into 1 of 3 groups. In Group A, patients' periocular skin and bulbar conjunctivae underwent preparation with 5% povidone-iodine; the drape was placed without regard to eyebrows; and an open wire-loop lid speculum was used. Group B patients underwent the same preparation as Group A patients; however, the eyelashes and eyebrows were scrubbed with 5% povidone-iodine on cotton tip applicators, and the drape was placed to exclude the eyebrows from the surgical field. Group C patients underwent the same preparation as Group B patients; however, a bladed lid speculum was used during surgery to exclude some of the eyelashes from the surgical field. After the procedure, all needles and suture materials were sent separately for aerobic culture. The data were analyzed for differences in contamination rates between the groups.
  
  
  RESULTS
  Of 77 patients, 24 (31.4%) had either a needle and/or suture contaminant. Groups A, B, and C had mean contamination rates of 29.6%, 34.6%, and 29.2%, respectively. There was no significant statistical variation in contamination among the 3 groups. The most common organism identified was a coagulase-negative staphylococcus strain.
  
  
  CONCLUSIONS
  More meticulous sterile preparation of the surgical field did not result in a meaningful reduction in suture or needle contamination rates during strabismus surgery.
authors.affiliation: Department of Ophthalmology, Nationwide Children's Hospital, Columbus, Ohio 43205, USA. david.rogers@nationwidechildrens.org
authors.forename: David L
authors.initials: DL
authors.lastname: Rogers
authors.forename: Lena
authors.initials: L
authors.lastname: Chheda
authors.forename: Carla
authors.initials: C
authors.lastname: Ford
authors.forename: Mario
authors.initials: M
authors.lastname: Marcon
authors.forename: Rae R
authors.initials: RR
authors.lastname: Fellows
authors.forename: Gary L
authors.initials: GL
authors.lastname: Rogers
authors.forename: Don L
authors.initials: DL
authors.lastname: Bremer
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: McGregor
authors.forename: Richard P
authors.initials: RP
authors.lastname: Golden
authors.forename: Cybil Bean
authors.initials: CB
authors.lastname: Cassady
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D001419:Bacteria / Q000302:isolation & purification; D058491:Bacterial Load; D009877:Endophthalmitis / Q000517:prevention & control; D004866:Equipment Contamination / Q000517:prevention & control*; D005138:Eyebrows / Q000187:drug effects / Q000382:microbiology; D005140:Eyelashes / Q000187:drug effects / Q000382:microbiology; D006801:Humans; D009339:Needles / Q000382:microbiology*; D009801:Oculomotor Muscles / Q000601:surgery; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011206:Povidone-Iodine / Q000008:administration & dosage; D013285:Strabismus / Q000601:surgery*; D013537:Sutures / Q000382:microbiology*
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine