Osterhoff Georg, Spirig José, Klasen Jürgen, Kuster Stefan P, Zinkernagel Annelies S, Sax Hugo, Min Kan
Department of Orthopedics, Balgrist Clinic, University of Zurich, Zurich, Switzerland.
Med Princ Pract. 2014;23(4):302-6. doi: 10.1159/000362794. Epub 2014 Jun 4.
To determine the integrity of microscope covers and bacterial contamination at the end of lumbar spinal decompressive surgery.
A prospective study of 25 consecutive lumbar spinal decompressions with the use of a surgical microscope was performed. For detection of perforations, the microscope covers were filled with water at the end of surgery and the presence of water leakage in 3 zones (objective, ocular and control panel) was examined. For detection of bacterial contamination, swabs were taken from the covers at the same locations before and after surgery.
Among the 25 covers, 1 (4%) perforation was observed and no association between perforation and bacterial contamination was seen; 3 (4%) of 75 smears from the 25 covers showed post-operative bacterial contamination, i.e. 2 in the ocular zone and 1 in the optical zone, without a cover perforation.
The incidence of microscope cover perforation was very low and was not shown to be associated with bacterial contamination. External sources of bacterial contamination seem to outweigh the problem of contamination due to failure of cover integrity.
确定腰椎减压手术后显微镜盖的完整性及细菌污染情况。
对连续25例使用手术显微镜进行腰椎减压手术的患者进行前瞻性研究。为检测穿孔情况，在手术结束时向显微镜盖中注水，并检查3个区域（物镜、目镜和控制面板）是否有水泄漏。为检测细菌污染情况，在手术前后从相同位置采集显微镜盖的拭子。
在25个显微镜盖中，观察到1个（4%）穿孔，且未发现穿孔与细菌污染之间存在关联；25个显微镜盖的75份涂片中有3份（4%）显示术后有细菌污染，即目镜区域2份，光学区域1份，且显微镜盖未穿孔。
显微镜盖穿孔的发生率非常低，且未显示与细菌污染有关。细菌污染的外部来源似乎比因盖完整性失效导致的污染问题更为严重。
