Bacterial contamination of suction catheter tips during aortic valve replacement surgery: a prospective observational cohort study

Abstract

BackgroundBacterial mediastinitis is a severe complication after open heart surgery. The infection causes prolonged hospitalization and an increased mortality risk. Observations from orthopaedic surgery showed that the suction catheter used during surgery is commonly contaminated with bacteria. The aim of this study was to describe the prevalence of suction catheter contamination in cardiac surgery and to study if suction time influences the contamination risk.MethodsFifty suction catheter tips were collected during 25 aortic valve replacement operations. The suction tip was exchanged once during the operation (after aortotomy closure). The tips were subjected to bacterial contamination analysis.ResultsIn 20 of the 25 investigated cases (80%), bacterial contamination was detected on one or both tips. The tip used during the beginning of the operation showed bacterial contamination in 13/25 cases (52%) and the second tip in 12/25 (48%). In 5/25 cases (20%) both tips were contaminated. There was no association between bacterial contamination and suction time. Coagulase-negative staphylococcus was the most commonly detected microorganism.ConclusionsThe suction device should be considered as a potential source of bacterial contamination in cardiac surgery. The results suggest that the suction catheter should be replaced before key moments like valve implantation and sternal closure.

Mediastinite após cirurgias valvares cardíacas: revisão integrativa

“…Os resultados de uma pesquisa (16) mostram que 80% dos cateteres de sucção utilizados no intraoperatório de cirurgias de substituição da valva aórtica apresentavam contaminação bacteriana, sendo o agente etiológico mais frequente o Estafilococos coagulase negativa, o mesmo autor inferiu que o tempo de sucção não aumentou o risco de contaminação dos cateteres. A contaminação por esse tipo de bactéria também foi encontrada em outros estudos (29)(30) que investigaram infecção do sítio cirúrgico em transplantes cardíacos e revascularização do miocárdio, respectivamente.…”

Suction Tip Colonization during Orthopedic Surgery: A Review

“…All authors agree that the most frequently isolated microorganisms are Staphylococcus, highlighting the importance of direct contamination of the skin or surgical wound and behavior during the surgery 8,20,21,24,25 .…”

“…The effect of the environment on the operating room has been investigated for several decades as a factor associated with SSIs and suction tip colonization due to airflow during the procedure 17,20,21 ; however, turbulence and the presence of airborne particles vary during the surgery. Chaveaux found an up to four times increase in contamination during limb preparation 22 , while Brown demonstrated a 4.4 times increase in contamination during dressing the patient 23 .…”

“…Greenough found a significant difference in suction tip colonization between changing it when aspirating the femoral canal and using the suction tip throughout the surgery 27 . Considering this difference, the suction tip should be replaced before executing critical steps of the procedure, such as implant fixation 21,27 . Time is the most important variable associated with colonization.…”

Contamination Rate of Burnt Necrotic Tissue after Electrocoagulation in Total Knee Arthroplasty

“…10) In particular, suction tips are the most frequently contaminated surgical instrument with the contamination rate ranging from 13.33% to 80%. 12,15,16) Hence, it has been recommended that some surgical equipment such as gloves and suction tips should be appropriately replaced during surgery. 17) The electrocautery device has become a fundamental surgical instrument commonly used for dissecting subcutaneous tissue, muscle, and fascia and controlling bleeding in surgery.…”