Ausen Kjersti, Kroknes Marthe L, Gunnarson Gudjon, Radtke Andreas
Section for Plastic and Reconstructive Surgery, Clinic of Surgery, St Olav's University Hospital, Trondheim, Norway.
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.
Plast Reconstr Surg Glob Open. 2021 Jun 15;9(6):e3635. doi: 10.1097/GOX.0000000000003635. eCollection 2021 Jun.
Fomites are surfaces that carry contaminants and may cause infection. We wanted to assess the bacterial load on rolls of nonsterile microporous tape in a hospital setting and explore the scientific rationale behind the existing practice of applying unsterile adhesives onto a surgical wound.
We analyzed the aerobic bacterial contamination in rolls of microporous tape collected from surgical theaters, outpatient clinics, and storage rooms at St. Olav's University Hospital, Trondheim, Norway between 2018 and 2020. We also reviewed the literature for relevant publications.
A total of 58 rolls were collected; 55 were included for final analysis. Exposed tape surfaces were significantly more contaminated than unexposed surfaces. Tape rolls from outpatient clinics were significantly more contaminated and contained a significantly greater variety of microbes than rolls from operation theaters and storage rooms. Unexposed surfaces from both operation theaters and storage rooms demonstrated very little contamination.
Rolls of tape may act as fomites, but widespread use of adhesives is inevitable in hospital settings. Removing the outer layer of a tape roll before use may significantly reduce bacterial contamination. Given sufficient vigilance to avoid cross-contamination, inner layers of tape may represent a close-to-sterile alternative as surgical dressing. However, the economic savings constitute a negligible fraction of the total costs of the surgery, and the risk of contamination seems apparent. Scientific support of dressing a fresh surgical wound with unsterile microporous tape is lacking, and we therefore do not recommend the practice except in situations with very limited resources.
污染物载体表面可能会导致感染。我们想要评估医院环境中无菌微孔胶带卷上的细菌载量，并探究将未消毒的粘合剂应用于手术伤口这一现有做法背后的科学依据。
我们分析了2018年至2020年期间从挪威特隆赫姆市圣奥拉夫大学医院的手术室、门诊诊所和储藏室收集的微孔胶带卷上的需氧菌污染情况。我们还查阅了相关文献以获取相关出版物。
共收集了58卷胶带；55卷纳入最终分析。胶带暴露表面的污染程度明显高于未暴露表面。门诊诊所的胶带卷污染程度明显更高，且所含微生物种类明显多于手术室和储藏室的胶带卷。手术室和储藏室的未暴露表面污染极少。
胶带卷可能充当污染物载体，但在医院环境中广泛使用粘合剂不可避免。使用前去除胶带卷的外层可显著减少细菌污染。在充分警惕以避免交叉污染的情况下，胶带内层可作为接近无菌的手术敷料替代品。然而，节省的费用在手术总成本中占比可忽略不计，且污染风险似乎很明显。缺乏用未消毒的微孔胶带包扎新鲜手术伤口的科学依据，因此，我们不建议采用这种做法，除非在资源非常有限的情况下。
