The extent of environmental and body contamination through aerosols by hydro-surgical debridement in the lumbar spine.
BACKGROUND
Surgical site infections occur in 1-6% of spinal surgeries. Effective treatment includes early diagnosis, parenteral antibiotics and early surgical debridement of the wound surface.


METHODS
On a human cadaver, we executed a complete hydro-surgery debridement including a full surgical setup such as draping. The irrigation fluid was artificially contaminated with Staphylococcus aureus (ATCC 6538). Surveillance cultures were used to detect environmental and body contamination of the surgical team.


RESULTS
For both test setups, environmental contamination was observed in an area of 6 × 8 m. Both test setups caused contamination of all personnel present during the procedure and of the whole operating theatre. However, the concentration of contamination for the surgical staff and the environment was lower when an additional disposable draping device was used.


CONCLUSIONS
The study showed that during hydro-surgery debridement, contaminated aerosols spread over the whole surgical room and contaminate the theatre and all personnel.
Department of Orthopaedic Surgery, Experimental Orthopaedics, Medical University Innsbruck, Innrain 36, 6020, Innsbruck, Austria.
David
D
Putzer
Department of Orthopaedic Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
Ricarda
R
Lechner
Department of Orthopaedic Surgery, Experimental Orthopaedics, Medical University Innsbruck, Innrain 36, 6020, Innsbruck, Austria.
Debora
D
Coraca-Huber
Division of Hygiene and Medical Microbiology, Department of Hygiene, Microbiology, and Social Medicine, Medical University Innsbruck, Fritz-Pregl-Straße 3, 6020, Innsbruck, Austria.
Astrid
A
Mayr
Department of Orthopaedic Surgery, Experimental Orthopaedics, Medical University Innsbruck, Innrain 36, 6020, Innsbruck, Austria.
Michael
M
Nogler
Department of Orthopaedic Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. martin.thaler@i-med.ac.at.
Martin
M
Thaler
D000336:Aerosols / Q000009:adverse effects*; D002102:Cadaver; D003264:Containment of Biohazards / Q000009:adverse effects*; D003646:Debridement / Q000009:adverse effects*; D004783:Environmental Microbiology; D004866:Equipment Contamination; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D016273:Occupational Exposure; D009873:Operating Rooms; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000209:etiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology
D000336:Aerosols
Contamination operating room; Hydro-surgery device; Infection; Spine; Surgical debridement