Agarwal Aakash, Schultz Christian, Agarwal Anand K, Wang Jeffrey C, Garfin Steve R, Anand Neel
University of Toledo, Toledo, OH, USA.
Apex Spine, Munich, Germany.
Global Spine J. 2019 Apr;9(2):173-178. doi: 10.1177/2192568218784298. Epub 2018 Jun 25.
It consisted of evaluation of the pedicle screws for presence of residual nonmicrobial contaminants and tabulation of the minimum steps and time required for reprocessing implants as per guidelines and its comparison with actual practice.
An evaluation of the nonmicrobial contaminants prevalent on the pedicle screws used for spine surgery and the underlying practice cause behind the source.
The first component consisted of a random selection of 6 pedicle screws and its assessment using optical microscopy, scanning electron microscopy with energy dispersive spectroscopy, and Fourier transform infrared spectroscopy. The second component consisted of review of implant reprocessing guidelines and its applicability.
Three types of contaminants were identified: corrosion, saccharide of unknown origin, and soap residue mixed with and were mostly present at the interfaces with low permeability. In addition, manufacturer's guideline recommends 19 hours of reprocessing, whereas the real-time observation revealed a turnaround time of 1 hour 17 minutes.
Repeatedly reprocessed pedicle screws host corrosion, carbohydrate, fat, and soap, which could be a cause of surgical site infection and inflammatory responses postsurgery. The cause behind it is the impracticality of repeated cleaning and inspection of such devices.
该研究包括评估椎弓根螺钉是否存在残留的非微生物污染物，按照指南将再处理植入物所需的最少步骤和时间制成表格，并将其与实际操作进行比较。
评估脊柱手术中使用的椎弓根螺钉上普遍存在的非微生物污染物以及其来源背后的实际操作原因。
第一部分包括随机选择6枚椎弓根螺钉，并使用光学显微镜、带能谱的扫描电子显微镜和傅里叶变换红外光谱对其进行评估。第二部分包括审查植入物再处理指南及其适用性。
识别出三种类型的污染物：腐蚀物、来源不明的糖类以及混合的肥皂残留物，且大多存在于低渗透性的界面处。此外，制造商的指南建议再处理时间为19小时，而实际观察显示周转时间为1小时17分钟。
反复再处理的椎弓根螺钉存在腐蚀、碳水化合物、脂肪和肥皂，这可能是手术部位感染和术后炎症反应的原因。其背后的原因是对此类器械进行反复清洁和检查不切实际。
