Microbial colonisation of orthopaedic tourniquets: A potential risk for surgical site infection

Sahu, Susanta Kumar; Tudu, Barsha; Mall, P K

doi:10.4103/0255-0857.150910

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…Non-sterile tourniquets are routinely used in orthopedic surgery in our hospital to obtain a bloodless field. Sahu et al recommend routine treatment of orthopedic tourniquets with a disinfectant, preferably an alcohol-based solution, to reduce the risk of contamination of the surgical field [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Development of a nomogram to predict surgical site infection after open reduction and internal fixation for closed pilon fracture: a prospective single-center study

Xie

Wang

et al. 2023

J Orthop Surg Res

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Background To explore the risk factors and develop a nomogram in order to predict surgical site infection (SSI) after open reduction and internal fixation (ORIF) for closed pilon fractures (CPF). Methods A prospective cohort study with one-year follow-up was carried out in a provincial trauma center. From January 2019 to January 2021, 417 adult patients with CPFs receiving ORIF were enrolled. A Whitney U test or t test, Pearson chi-square test, and multiple logistic regression analyses were gradually used for screening the adjusted factors of SSI. A nomogram model was built to predict the risk of SSI, and the concordance index (C-index), the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used for evaluating the prediction performance and consistency of the nomogram model. The bootstrap method was employed to test the validity of the nomogram. Results The incidence of SSI after ORIF for CPFs was 7.2% (30/417): 4.1% (17/417) of superficial SSIs and 3.1% (13/417) of deep SSIs. The most common pathogenic bacteria were Staphylococcus aureus (36.6%, 11/30). The multivariate analysis showed tourniquet use, longer preoperative stay, lower preoperative albumin (ALB), higher preoperative body mass index (BMI) and hypersensitive C-reactive protein (Hs-CRP) were independent risk factors of SSI. Additionally, the C-index and bootstrap value of the nomogram model were 0.838 and 0.820, respectively. Finally, the calibration curve indicated that the actual diagnosed SSI had good consistency with the predicted probability, and the DCA showed that the nomogram had clinical value. Conclusions Tourniquet use, longer preoperative stay, lower preoperative ALB, higher preoperative BMI and Hs-CRP were five independent risk factors of SSI after closed pilon fractures treated by ORIF. These five predictors are shown on the nomogram, with which we may be able to further prevent the CPS patients from SSI. Trial registration NO 2018-026-1, October /24/2018, prospectively registered. The study was registered in October 24, 2018. The study protocol was designed based on the Declaration of Helsinki and admitted by the Institutional Review Board. The ethics committee approved the study on factors related to fracture healing in orthopedic surgery. Data analyzed in the present study were acquired from the patients who underwent open reduction and internal fixation from January 2019 to January 2021.

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Section: Discussionmentioning

confidence: 99%

Development of a nomogram to predict surgical site infection after open reduction and internal fixation for closed pilon fracture: a prospective single-center study

Xie

Wang

et al. 2023

J Orthop Surg Res

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“…Mufarrih et al found that a weekly cleaning protocol consisting of soaking tourniquets for 30 minutes in sodium hypochlorite eliminated growth of all organisms. Similarly, Sahu et al showed that a cleaning protocol using either alcohol or chlorhexidine wipes led to a 92% to 95% reduction in colony counts on all 16 tourniquets 70 . These studies suggest that tourniquets can be safely reused if appropriate cleaning protocols are implemented.…”

Section: Tourniquetsmentioning

confidence: 96%

Reuse of Orthopaedic Equipment

Tsay,

Sabharwal

2024

JBJS Reviews

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» Reuse of orthopaedic equipment is one of many potential ways to minimize the negative impact of used equipment on the environment, rising healthcare costs and disparities in access to surgical care.» Barriers to widespread adoption of reuse include concerns for patient safety, exposure to unknown liability risks, negative public perceptions, and logistical barriers such as limited availability of infrastructure and quality control metrics.» Some low- and middle-income countries have existing models of equipment reuse that can be adapted through reverse innovation to high-income countries such as the United States.» Further research should be conducted to examine the safety and efficacy of reusing various orthopaedic equipment, so that standardized guidelines for reuse can be established.

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