Jennings Jason M, Johnson Roseann M, Brady Anna C, Stuckey Whitney P, Pollet Aviva K, Dennis Douglas A
Colorado Joint Replacement, Denver, CO, USA.
Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, USA.
Arthroplast Today. 2022 Aug 15;17:53-57. doi: 10.1016/j.artd.2022.07.002. eCollection 2022 Oct.
Periprosthetic joint infection may result from pathogen to patient transmission within the environment. The purpose of this study is to evaluate the contamination level of selected high-touch surfaces in the operating room (OR) using a blacklight fluorescent marking system after a manual terminal clean.
Prior to the manual terminal clean, 16 high-touch surfaces were marked using a blacklight fluorescent gel. The marked areas were assessed the next morning for thoroughness of cleaning. Surfaces were categorized based on the average percent of the marks removed as "clean" (>75%), "partially clean" (26%-74%), or poorly cleaned (<25%). This process was repeated randomly 12 times. Terminal cleaning was done in the standard fashion, and the perioperative team was unaware of the initiation of this study.
A total of 936 marks were analyzed. There was a significant difference in the number of marks completely clean (29.1%, 272/936) vs marks that were not touched (40.8%, 382/936), < .001. Only the OR back table (75%) had a rating of clean. Partially clean areas included Mayfield table (72%), overhead lights (70.1%), infusion pump (61.1%), clock reset button (58.3%), table remote control (50%), tourniquet machine (50%), and the OR table (33.3%). Poorly cleaned surfaces included anesthesia medication cart (21.8%), door handles (20.8%), phone (16.7%), electrocautery unit (16.7%), foot pedal (16.7%), anesthesia cart (16.2%), nurses' station (14.1%), and supply cabinet doors (6%).
Effectiveness of manual terminal cleaning varied greatly across surfaces. In general, surfaces further from the operative field were less likely to have markings removed.
假体周围关节感染可能源于病原体在环境中传播至患者。本研究的目的是使用黑光荧光标记系统评估手术室（OR）中选定的高接触表面在手动终末清洁后的污染水平。
在手动终末清洁前，使用黑光荧光凝胶标记16个高接触表面。次日早晨评估标记区域的清洁彻底程度。根据去除标记的平均百分比将表面分类为“清洁”（>75%）、“部分清洁”（26%-74%）或清洁不佳（<25%）。此过程随机重复12次。终末清洁以标准方式进行，围手术期团队不知晓本研究的启动。
共分析了936个标记。完全清洁的标记数量（29.1%，272/936）与未被触及的标记数量（40.8%，382/936）存在显著差异，P<0.001。只有手术室后桌（75%）评级为清洁。部分清洁区域包括梅菲尔德头架（72%）、顶灯（70.1%）、输液泵（61.1%）、时钟重置按钮（58.3%）、手术台遥控器（50%）、止血带机（50%）和手术台（33.3%）。清洁不佳的表面包括麻醉药车（21.8%）、门把手（20.8%）、电话（16.7%）、电灼器（16.7%）、脚踏板（16.7%）、麻醉推车（16.2%）、护士站（14.1%）和供应柜门（6%）。
手动终末清洁的效果在不同表面差异很大。一般来说，离手术区域较远的表面去除标记的可能性较小。
