Abdelaziz Hussein, Zahar Akos, Lausmann Christian, Gehrke Thorsten, Fickenscher Helmut, Suero Eduardo M, Gebauer Matthias, Citak Mustafa
Department of Orthopaedic Surgery, Helios ENDO-Klinik, Holstenstr. 2, 22767, Hamburg, Germany.
Institute for Infection Medicine, Kiel University, Kiel, Germany.
Int Orthop. 2018 Apr;42(4):755-760. doi: 10.1007/s00264-018-3822-1. Epub 2018 Feb 12.
The aim of the study was to quantify the bacterial contamination rate of electrocautery tips during primary total joint replacement (TJR), as well as during aseptic and septic revision TJR.
A total of 150 electrocautery tips were collected between April and July 2017. TJR surgeries were divided into three groups: (1) primary, (2) aseptic and (3) septic revisions. In each group, a total of 50 electrocautery tips were collected. A monopolar electrocautery with a reusable stainless-steel blade tip was used in all cases. The rate of bacterial contamination was determined for all groups. Correlation of exposure time and type of surgery was analyzed.
The overall bacterial contamination rate was 14.7% (95% CI 9.4 to 21.4%). The highest contamination rate occurred in the septic revision group (30.0%; 95% CI 17.9 to 44.6%), followed by the primary cases group (10.0%; 95% CI 3.3 to 21.8%) and the aseptic revision group (4.0%; 95% CI 0.5 to 13.7%). Exposure time did not affect the bacterial contamination rate. In 12 out of 15 (80%) contaminations identified in the septic group, we found the same causative microorganism of the prosthetic joint infection on the electrocautery tip.
The bacterial contamination of the electrocautery tips is relatively high, especially during septic hip revision arthroplasty. Electrocautery tips should be changed after debridement of infected tissue.
本研究旨在量化初次全关节置换（TJR）期间以及无菌和感染性翻修TJR期间电灼头的细菌污染率。
2017年4月至7月共收集了150个电灼头。TJR手术分为三组：（1）初次手术，（2）无菌翻修和（3）感染性翻修。每组共收集50个电灼头。所有病例均使用带有可重复使用不锈钢刀片尖端的单极电灼器。测定所有组的细菌污染率。分析暴露时间与手术类型的相关性。
总体细菌污染率为14.7%（95%CI 9.4至21.4%）。污染率最高的是感染性翻修组（30.0%；95%CI 17.9至44.6%），其次是初次手术组（10.0%；95%CI 3.3至21.8%）和无菌翻修组（4.0%；95%CI 0.5至13.7%）。暴露时间不影响细菌污染率。在感染组确定的15例污染中有12例（80%），我们在电灼头上发现了与人工关节感染相同的致病微生物。
电灼头的细菌污染率相对较高，尤其是在感染性髋关节翻修置换术中。在清创感染组织后应更换电灼头。
