The relative importance of routes and sources of wound contamination during general surgery. I. Non-airborne

Abstract

A study was undertaken to determine the relative importance of some sources, routes of transmission, and measures to prevent bacteria entering the wound during biliary tract surgery. When bacteria were growing in the bile they accounted for the majority (greater than 99%) of the bacteria found in the wound. However, when the bile was sterile the skin bacteria at the incision site were found to make a substantial contribution to the wound flora. The difference in the total wound contamination between a patient who had practically no skin bacteria and one who had an average amount was in the region of 17-fold. No transfer of skin bacteria from the surgical team through perforated gloves or by direct contact from the surface of operating gowns was demonstrated. Ten of the patients studied had septic wounds. Five of these were infected by bacteria from the bile.

Surgeon's garb and infection control: What's the evidence?

“…[92][93][94] Also, Devenish and Miles 95 showed that when cotton gowns get wet, skin organisms readily penetrate the gown. In 1952 Beck and Collette 96 published an article entitled ''False faith in the surgeon's gown and surgical drape,'' which described the shortcomings of J AM ACAD DERMATOL VOLUME 64, NUMBER 5 Eisen 960.e10 surgery garments constructed out of 140 thread count cotton. 97 An explosion of research into the development of new gowns and different types of garment materials occurred as a result.…”

“…Most SSIs are thought to arise from the patient's own endogenous flora and from that of the operating room (OR) staff. [3][4][5][6][7] The use of specialized garb is meant to reduce the chances for transfer of bacteria from the surgery staff to the patient.…”

Myths and Legends in Orthopaedic Practice: Are We All Guilty?

“…It is common practice among surgeons of all specialties to discard the scalpel blade used for the skin incision and to use a fresh blade for deeper dissection, the logic being although the skin surface is rendered sterile by preoperative scrubbing, as much as 20% of skin bacteria may remain in skin sweat glands and hair follicles and are potentially the source of wound flora [40,115,130]. However, evidence suggests the practice of changing the blade is unnecessary [26,40,50,57,60,88,102,119].…”

IKOP?Infektionskontrolle im Operationsbereich

“…Ziel der Patientenvorbereitung ist die weit gehende Reduktion der Erregerlast auf der Haut durch die gründliche Hautdesinfektion. Eine exogene Kontamination der Operationswunde durch direkten Kontakt ist jedoch ebenfalls von großer Bedeutung [63,64]. Ein dritter Weg der Kontamination besteht in der aerogenen Übertragung [17,32,33,34].…”