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General Orthopaedics

PELVIC SUPPORTS – POTENTIAL SOURCE OF CROSS-INFECTION IN HIP SURGERY?

British Orthopaedic Specialists Association (BOSA)



Abstract

Queen Elizabeth the Queen Mother Hospital, Margate, East Kent Hospitals NHS University Trust, UK.

PURPOSE

Surfaces of supports used to position patients for hip replacement are usually are in direct contact with the patient skin around the groin/buttock areas & repeated use of same supports, in trauma & elective surgeries, can be a source of cross-infection & wound contamination.

MATERIALS AND RESULTS

Swab samples from 12 supports, employed interchangeably for elective & trauma surgery. Cultured & incubated at 37 0 C in Columbia Blood Agar. 2 random supports cleaned using Sani Cloth Detergent non-alcoholic wipes & 2 samples were obtained from each support, 5 min later.

71% sampled supports were contaminated, with Coagulase-negative Staphylococcus, including Staph Epidermidis, being the most commonly grown organism with average of 5.3 colony forming units (CFU) (0-38) per swab. 5 min after cleaning 2 of above supports there was a 100% reduction in their contamination with no growth from the 4 swabs.

CONCLUSION

Trauma patients are not necessarily subjected to groin MRSA swabs pre-operatively in contrast to patients undergoing elective hip surgery who are rigorously swabbed for the same & interchangeable use of hip supports in trauma and elective patients defeats the purpose of this practice considering the fact that Coagulase -ve Staphylococci like Staph epidermidis, reside on the hip supports presently used in the orthopaedic theatre. We recommend strict cleaning of these supports for 5 min with the detergent wipes before & between every orthopaedic hip case & where feasible, the supports used should be different for elective and trauma cases.