Microscope sterility during spine surgery

Jesse Bible, Kevin R. O'Neill, Colin G. Crosby, Jonathan G. Schoenecker, Matthew J. McGirt, Clinton J. Devin

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

STUDY DESIGN.: Prospective study. OBJECTIVE.: Assess the contamination rates of sterile microscope drapes after spine surgery. SUMMARY OF BACKGROUND DATA.: The use of the operating microscope has become more prevalent in certain spine procedures, providing superior magnification, visualization, and illumination of the operative field. However, it may represent an additional source of bacterial contamination and increase the risk of developing a postoperative infection. METHODS.: This study included 25 surgical spine cases performed by a single spine surgeon that required the use of the operative microscope. Sterile culture swabs were used to obtain samples from 7 defined locations on the microscope drape after its use during the operation. The undraped technician's console was sampled in each case as a positive control, and an additional 25 microscope drapes were swabbed immediately after they were applied to the microscope to obtain negative controls. Swab samples were assessed for bacterial growth on 5% sheep blood Columbia agar plates using a semiquantitative technique. RESULTS.: No growth was observed on any of the 25 negative control drapes. In contrast, 100% of preoperative and 96% of postoperative positive controls demonstrated obvious contamination. In the postoperative group, all 7 sites of evaluation were found to be contaminated with rates of 12% to 44%. Four of the 7 evaluated locations were found to have significant contamination rates compared with negative controls, including the shafts of the optic eyepieces on the main surgeon side (24%, P = 0.022), "forehead" portion on both the main surgeon (24%, P = 0.022) and assistant sides (28%, P = 0.010), and "overhead" portion of the drape (44%, P = 0.0002). CONCLUSION.: Bacterial contamination of the operative microscope was found to be significant after spine surgery. Contamination was more common around the optic eyepieces, likely due to inadvertent touching of unsterile portions. Similarly, all regions above the eyepieces also have a propensity for contamination because of unknown contact with unsterile parts of the surgeon. Therefore, we believe that changing gloves after making adjustments to the optic eyepieces and avoid handling any portion of the drape above the eyepieces may decrease the risks of intraoperative contamination and possibly postoperative infection as well.

Original languageEnglish (US)
Pages (from-to)623-627
Number of pages5
JournalSpine
Volume37
Issue number7
DOIs
StatePublished - Apr 1 2012

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Infertility
Spine
Forehead
Growth
Infection
Lighting
Agar
Sheep
Prospective Studies
Surgeons

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Bible, J., O'Neill, K. R., Crosby, C. G., Schoenecker, J. G., McGirt, M. J., & Devin, C. J. (2012). Microscope sterility during spine surgery. Spine, 37(7), 623-627. https://doi.org/10.1097/BRS.0b013e3182286129
Bible, Jesse ; O'Neill, Kevin R. ; Crosby, Colin G. ; Schoenecker, Jonathan G. ; McGirt, Matthew J. ; Devin, Clinton J. / Microscope sterility during spine surgery. In: Spine. 2012 ; Vol. 37, No. 7. pp. 623-627.
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Bible, J, O'Neill, KR, Crosby, CG, Schoenecker, JG, McGirt, MJ & Devin, CJ 2012, 'Microscope sterility during spine surgery', Spine, vol. 37, no. 7, pp. 623-627. https://doi.org/10.1097/BRS.0b013e3182286129

Microscope sterility during spine surgery. / Bible, Jesse; O'Neill, Kevin R.; Crosby, Colin G.; Schoenecker, Jonathan G.; McGirt, Matthew J.; Devin, Clinton J.

In: Spine, Vol. 37, No. 7, 01.04.2012, p. 623-627.

Research output: Contribution to journalArticle

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N2 - STUDY DESIGN.: Prospective study. OBJECTIVE.: Assess the contamination rates of sterile microscope drapes after spine surgery. SUMMARY OF BACKGROUND DATA.: The use of the operating microscope has become more prevalent in certain spine procedures, providing superior magnification, visualization, and illumination of the operative field. However, it may represent an additional source of bacterial contamination and increase the risk of developing a postoperative infection. METHODS.: This study included 25 surgical spine cases performed by a single spine surgeon that required the use of the operative microscope. Sterile culture swabs were used to obtain samples from 7 defined locations on the microscope drape after its use during the operation. The undraped technician's console was sampled in each case as a positive control, and an additional 25 microscope drapes were swabbed immediately after they were applied to the microscope to obtain negative controls. Swab samples were assessed for bacterial growth on 5% sheep blood Columbia agar plates using a semiquantitative technique. RESULTS.: No growth was observed on any of the 25 negative control drapes. In contrast, 100% of preoperative and 96% of postoperative positive controls demonstrated obvious contamination. In the postoperative group, all 7 sites of evaluation were found to be contaminated with rates of 12% to 44%. Four of the 7 evaluated locations were found to have significant contamination rates compared with negative controls, including the shafts of the optic eyepieces on the main surgeon side (24%, P = 0.022), "forehead" portion on both the main surgeon (24%, P = 0.022) and assistant sides (28%, P = 0.010), and "overhead" portion of the drape (44%, P = 0.0002). CONCLUSION.: Bacterial contamination of the operative microscope was found to be significant after spine surgery. Contamination was more common around the optic eyepieces, likely due to inadvertent touching of unsterile portions. Similarly, all regions above the eyepieces also have a propensity for contamination because of unknown contact with unsterile parts of the surgeon. Therefore, we believe that changing gloves after making adjustments to the optic eyepieces and avoid handling any portion of the drape above the eyepieces may decrease the risks of intraoperative contamination and possibly postoperative infection as well.

AB - STUDY DESIGN.: Prospective study. OBJECTIVE.: Assess the contamination rates of sterile microscope drapes after spine surgery. SUMMARY OF BACKGROUND DATA.: The use of the operating microscope has become more prevalent in certain spine procedures, providing superior magnification, visualization, and illumination of the operative field. However, it may represent an additional source of bacterial contamination and increase the risk of developing a postoperative infection. METHODS.: This study included 25 surgical spine cases performed by a single spine surgeon that required the use of the operative microscope. Sterile culture swabs were used to obtain samples from 7 defined locations on the microscope drape after its use during the operation. The undraped technician's console was sampled in each case as a positive control, and an additional 25 microscope drapes were swabbed immediately after they were applied to the microscope to obtain negative controls. Swab samples were assessed for bacterial growth on 5% sheep blood Columbia agar plates using a semiquantitative technique. RESULTS.: No growth was observed on any of the 25 negative control drapes. In contrast, 100% of preoperative and 96% of postoperative positive controls demonstrated obvious contamination. In the postoperative group, all 7 sites of evaluation were found to be contaminated with rates of 12% to 44%. Four of the 7 evaluated locations were found to have significant contamination rates compared with negative controls, including the shafts of the optic eyepieces on the main surgeon side (24%, P = 0.022), "forehead" portion on both the main surgeon (24%, P = 0.022) and assistant sides (28%, P = 0.010), and "overhead" portion of the drape (44%, P = 0.0002). CONCLUSION.: Bacterial contamination of the operative microscope was found to be significant after spine surgery. Contamination was more common around the optic eyepieces, likely due to inadvertent touching of unsterile portions. Similarly, all regions above the eyepieces also have a propensity for contamination because of unknown contact with unsterile parts of the surgeon. Therefore, we believe that changing gloves after making adjustments to the optic eyepieces and avoid handling any portion of the drape above the eyepieces may decrease the risks of intraoperative contamination and possibly postoperative infection as well.

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Bible J, O'Neill KR, Crosby CG, Schoenecker JG, McGirt MJ, Devin CJ. Microscope sterility during spine surgery. Spine. 2012 Apr 1;37(7):623-627. https://doi.org/10.1097/BRS.0b013e3182286129