High bacterial contamination rate of electrocautery tips during total hip and knee arthroplasty
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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.
KeywordsElectrocautery tips Periprosthetic joint infection (PJI) Surgical site infection (SSI) Intra-operative contamination Bacterial Total knee arthroplasty Total hip arthroplasty
The authors acknowledge the support of Dr. S. Schubert and Dr. A. Büter. The work of the study coordinator, Mrs. Gabriele Paprotzki; of Carola Hogrefe (study nurse); and of Dr. Silke Lange (statistician) is also appreciated.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was performed after obtaining approval from the institutional review board. The PV number is “PV5476.”
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