Suction Tip Colonization during Orthopedic Surgery: A Review

Abstract

Surgical site infections are clinically and epidemiologically critical in orthopedic surgery, as they lead to several complications affecting the quality of life of patients. Contamination may occur during the surgery, through instruments directly inserted into the wound acting as reservoirs for microorganisms. This study aimed to review the literature on suction tip colonization during orthopedic surgery, with an aim toward setting guidelines for its management during surgical procedures. Suction tips can be colonized primarily in two ways. The first is through direct contact with a surgical wound or poor handling by surgical staff and the second is through continuous airflow through the tip of the suction. Colonization rate between studies has decreased in the last years reporting in recent papers a 7.3% suction tips colonization rates in clean orthopedic. The most common germs isolated are S. epidermidis, S. aureus and E. cloacae. Suction tip colonization has a direct relationship with the duration of the surgical procedure, with a higher rate of colonization with longer surgeries. Multiple strategies have been proposed to reduce the risk of colonization of the suction tips used during a surgical procedure including systematically changing suction cannula after 1 hour of surgery or strategies to reduce active suction time. It is unclear if suction tip colonization is directly related to surgical site infection rates. Further studies are needed to corelate infection and colonization of the suction canula.