The Relationship Between Holding Time and the Bacterial Load on Surgical Instruments

Perçin, Duygu; Sav, Hafıze; Hörmet-Öz, Hatice Tuna; Karauz, Murat

doi:10.1007/s12262-012-0725-z

Cited by 14 publications

(18 citation statements)

References 4 publications

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“…The increase in contact time led to an increase in the microbial load, reaching 10 3 CFU/cm 2 after 4 hours, 10 4 CFU/cm 2 in 6 hours and 10 5 CFU/cm 2 after 24 hours. Similar results were described in a surgical instrument also experimentally contaminated with E. coli, in which the microbial load, in the first 12 hours of incubation, varied between 10 2 CFU/cm 2 and 10 4 CFU/cm 2 , reaching 10 6 CFU/ cm 2 in 24 hours (19)(20)(21) .…”

Section: Discussionsupporting

confidence: 79%

Impact of the contamination time by Escherichia coli on biofilm formation in surgical instruments

2021

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Objectives: to evaluate the microbial load and adherence of Escherichia coli in different areas of the surgical instrument surface exposed to experimental contamination over time. Methods: experimental study in which fragments of crile forceps (serrated, rod and rack) were contaminated by immersion in Tryptic Soy Broth, containing 106 CFU/mL of E. coli, for 1, 2, 4, 6, 8, 12 and 24 hours. Microbial load and bacterial adherence were evaluated using microbiological culture and scanning electron microscopy, respectively. Results: there was an increase in the microbial load on the surgical instrument, proportional to the contamination interval, ranging from 102 after 1 hour to 105 CFU/cm2 in 24 hours. The presence of exopolysaccharide was detected after two hours of contamination. Conclusions: microbial load and adhesion of E. coli increased over time, reaching 105 CFU/cm2 after 24 hours of contamination, starting biofilm formation after two hours.

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Section: Discussionsupporting

confidence: 79%

Impact of the contamination time by Escherichia coli on biofilm formation in surgical instruments

2021

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“…The literature search revealed two recent experimental studies addressing augmented bacterial growth on instruments not reprocessed within the recommended 6 h period [6,7]. In both studies, the instruments were contaminated with three common pathogenic bacteria with a quantification of bacterial growth at room temperature at various time-points.…”

Section: Discussionmentioning

confidence: 99%

Challenging the six-hour recommendation for reprocessing sterilizable medical equipment

Bundgaard

Ripadal

et al. 2019

Journal of Hospital Infection

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Background: At present, reprocessing of sterilizable medical equipment is recommended to be initiated within 6 h after completion of surgery, to ensure that the quality of the instruments does not deteriorate. A literature search showed a lack of evidence for consequences that may occur if medical personnel deviate from the standard 6 h sterilization protocol. Aim: To evaluate the 6 h recommendation for reprocessing sterilizable medical equipment by determining whether residual protein increased proportional to holding time before reprocessing was initiated, and likewise whether an increase in corrosion was present on surgical scissors proportional to holding time. Methods: Residual protein was identified on surgical instruments contaminated with human blood after different holding times and before washes using the o-phthaldialdehyde (OPA) method. Corrosion was identified on surgical scissors contaminated with human blood after different holding times and after reprocessing using light stereomicroscopy and scanning electron microscopy. Findings: Protein residues ranged between 14.0 and 51.9 mg and thus below the accepted threshold of 100 mg per instrument surface. Corrosion corresponding to 0.05% of the surface was identified on 22 of 30 scissors. Pitting corrosion was seen on four of 30 scissors. Conclusion: No association was identified between residual protein and holding time, nor between incidence of corrosion and holding time. The study thereby challenges the relevance of upholding the recommendation of a maximum wait of 6 h prior to reprocessing. The findings will potentially have an impact on the organization of reprocessing of surgical instruments in Denmark and internationally.

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“…This is commonly referred to as ‘extended sterilization cycle time’ ( 31 ). In general, standard cycle times can range from 5 to 20 minutes of exposure in a dynamic air-removal sterilizer at 132 °C and as long as one hour in a gravity cycle at 121 °C ( 32 ). The temperature for wrapped items (e.g., surgical drills) in a gravity-displacement cycle may be 121 °C for exposure time of 30 minutes, 132 °C for 15 minutes, or 135 °C for 10 minutes ( 11 - 13 ).…”

Section: Discussionmentioning

confidence: 99%

Pilot Study: Internally Cooled Orthopedic Drills – Standard Sterilization Is Not Enough?

Bruketa

Augustin

Pintarić

et al. 2019

ACC

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SUMMARYBone drilling causes focal temperature rise due to metal-to-bone contact, which may result in thermal osteonecrosis. Newly constructed internally cooled medical drill of an open type decreases temperature rise at a point of metal-to-bone contact although standard sterilization of such a drill could be inadequate due to bacteria retention within the drill lumen. The aim of this pilot study was to examine the effectiveness of sterilization and to propose sterilization recommendations for internally cooled open type bone drills. Unused internally cooled medical steel bone drills were tested. Drills were contaminated with Pseudomonas aeruginosa, Bacillus sp., beta-hemolytic Streptococcus sp., Enterobacter sp. and methicillin-resistant Staphylococcus pseudintermedius and then incubated for 24 hours at 37 °C. Afterwards, drills were autoclaved for 15, 20 and 30 minutes at 132 °C and 2.6 bar. When 15-minute sterilization was used, one out of 16 drills was contaminated with Pseudomonas aeruginosa, while the other 15 drills were sterile. Extended cycle sterilization in autoclave lasting for 20 and 30 minutes resulted in 100% sterility of all drills tested. In conclusion, lumened drills should be exposed to extended sterilization times in autoclave. Minimal recommended time for sterilization of lumened drills is 20 minutes.

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The Relationship Between Holding Time and the Bacterial Load on Surgical Instruments

Cited by 14 publications

References 4 publications

Impact of the contamination time by Escherichia coli on biofilm formation in surgical instruments

Impact of the contamination time by Escherichia coli on biofilm formation in surgical instruments

Challenging the six-hour recommendation for reprocessing sterilizable medical equipment

Pilot Study: Internally Cooled Orthopedic Drills – Standard Sterilization Is Not Enough?

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