Is retained bone debris in cannulated orthopedic instruments sterile after autoclaving?

Smith, Kenneth; Araoye, Ibukunoluwa; Gilbert, Shawn R.; Waites, Ken B.; Camins, Bernard; Conklin, Michael; Ponce, Brent A.

doi:10.1016/j.ajic.2018.02.024

Cited by 15 publications

(12 citation statements)

References 14 publications

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“…The researchers cultured nine cannulated drills that had been inoculated with a mixture of Bacillus cereus, P aeruginosa , and methicillin‐resistant Staphylococcus aureus after standard sterilization (a four‐minute, prevacuum, 270º‐F [132.2º‐C] cycle). Of the nine cannulated drills, one (11%) tested positive for a Bacillus species that was distinct from the original inoculated strain . This finding clearly supports the importance of effective cleaning protocols for surgical instruments before sterilization.…”

Section: Discussionsupporting

confidence: 57%

“…Of the nine cannulated drills, one (11%) tested positive for a Bacillus species that was distinct from the original inoculated strain. 24 This finding clearly supports the importance of effective cleaning protocols for surgical instruments before sterilization.…”

Section: Discussionsupporting

confidence: 54%

“…Some perioperative staff members assume retained bioburden is sterile if it has completed a sterilization process, but there is no evidence to support this assumption. An in vitro study concluded that cannulated drills may not be sterile after completion of standard sterilization cycles . The researchers cultured nine cannulated drills that had been inoculated with a mixture of Bacillus cereus, P aeruginosa , and methicillin‐resistant Staphylococcus aureus after standard sterilization (a four‐minute, prevacuum, 270º‐F [132.2º‐C] cycle).…”

Section: Discussionmentioning

confidence: 99%

“…An in vitro study concluded that cannulated drills may not be sterile after completion of standard sterilization cycles. 24 The researchers cultured nine cannulated drills that had been inoculated with a mixture of Bacillus cereus, P aeruginosa, and methicillin-resistant Staphylococcus aureus after standard sterilization (a four-minute, prevacuum, 270º-F [132.2º-C] cycle). Of the nine cannulated drills, one (11%) tested positive for a Bacillus species that was distinct from the original inoculated strain.…”

Section: Discussionmentioning

confidence: 99%

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Adenosine Triphosphate‐Bioluminescence Technology as an Adjunct Tool to Validate Cleanliness of Surgical Instruments

Rodriguez¹,

Hooper²

2019

AORN Journal

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Perioperative and sterile processing department personnel commonly use visual inspection to validate surgical instrument cleanliness. This validation process does not detect microbes (eg, bacteria, viruses) and the resultant inadequately decontaminated instruments can put patients at risk for developing surgical site infections. Sterile processing department personnel should use a rapid, straightforward method to validate surgical instrument cleanliness objectively. During a quality improvement project at a military treatment facility, staff members found that adenosine triphosphate (ATP)–based technology was a viable and affordable solution for detecting bioburden and validating cleaning practices. The project design compared manually and mechanically cleaned cannulated instruments (59 of each) and identified 16 contaminated instruments, 14 of which had been manually cleaned. The contamination rate after mechanical cleaning was significantly lower (P = .0022) compared with manual cleaning. As a result of this quality improvement project, this facility fully implemented the technology to validate instrument cleaning.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Adenosine Triphosphate‐Bioluminescence Technology as an Adjunct Tool to Validate Cleanliness of Surgical Instruments

Rodriguez¹,

Hooper²

2019

AORN Journal

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“…Wiser found that both soft tissue and bone resection resulted in a blunt shaver blade over time [11]. Smith confirmed that retained bone and other biodebris inside orthopedic instruments may not be sterile despite steam sterilization [22].…”

Section: Discussionmentioning

confidence: 99%

Assessment of arthroscopic shavers: a comparison test of resection performance and quality

Peng

Zhao

et al. 2020

J Orthop Surg Res

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Background: Arthroscopic shavers play an indispensable role in arthroscopic debridement. They have exquisite structures and similar designs. The purpose of this study was to establish a reproducible testing protocol to compare the resection performance and the quality (tensile strength, torsional strength, and corrosion resistance) of different arthroscopic shavers with comparable designs. We hypothesized that there could be little difference in resection performance and quality between these shavers. Methods: Incisor Plus Blade (IPB; Smith & Nephew, Andover, MA) and Double Serrated Plus Blade (DSPB; BJKMC, Shanghai, China) were selected for resection performance and quality test. For resection performance testing, the resection torque, which is the minimum torque required to cut off silicone blocks with the same cross-sectional area, was measured to evaluate the resection performance of shaver blades when the other factors remain the same. For quality testing, tensile and torsion tests of the shavers' joint part were performed, and ultimate failure load and maximum torque were measured and compared. The corrosion resistance of these blades was assessed by the boiling water test based on the ISO13402. Results: No significant difference existed in the resection torque between the shaver blades of IPB and DSPB (P = 0.54). To the failure load of shavers' joint parts, IPB was significantly higher than DSPB, both in the outer and inner blades (P < 0.0001). The maximum torque of the joint part had no significant difference between IPB and DSPB (for inner blades P = 0.60 and outer blades P = 0.94). The failure load (for both IPB and DSPB P < 0.0001) and maximum torque (for IPB P = 0.0475 and DSPB P = 0.015) of the inner blades were higher than those of the outer blades. No blemishes were observed on the surface of the blades after corrosion resistance tests. Conclusions: This study provided some new methods to evaluate the resection performance and quality of different shavers. The resection performance, the torsional strength of the joint part, and the corrosion resistance of IPB and DSPB may show comparable properties, whereas the tensile strength of the shavers' joint part showed some level of difference.

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Clinical Issues—July 2021

Wright¹,

Seeman²

2021

AORN Journal

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THIS MONTH Debris in sterilized instrument sets Key words: organic debris, inorganic debris, instrument sets, sterile processing, sterilizing agent.Preventing debris in sterilized instrument setsKey words: debris, instrument sets, sterile processing equipment, instructions for use (IFU), quality assurance.Bone cement precautions during pregnancyKey words: bone cement, exposure, methyl methacrylate (MMA), pregnant.Using a bed sheet or blanket for positioningKey words: patient positioning devices, improvised positioning device, pressure distribution, skin shear, pressure injury.Laundering of cloth head coveringsKey words: laundering, head covering, reusable cloth hat, surgical attire, disposable bouffant.

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Is retained bone debris in cannulated orthopedic instruments sterile after autoclaving?

Cited by 15 publications

References 14 publications

Adenosine Triphosphate‐Bioluminescence Technology as an Adjunct Tool to Validate Cleanliness of Surgical Instruments

Adenosine Triphosphate‐Bioluminescence Technology as an Adjunct Tool to Validate Cleanliness of Surgical Instruments

Assessment of arthroscopic shavers: a comparison test of resection performance and quality

Clinical Issues—July 2021

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