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Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine Surgery
STUDY DESIGN: A literature review. OBJECTIVES: An evaluation of the contaminants prevalent on implants used for surgery and the aseptic methods being employed against them. METHODS: PubMed was searched for articles published between 2000 and 2017 for studies evaluating the contaminants present on sp...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232723/ https://www.ncbi.nlm.nih.gov/pubmed/30443488 http://dx.doi.org/10.1177/2192568218762380 |
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author | Agarwal, Aakash Schultz, Christian Goel, Vijay K. Agarwal, Anand Anand, Neel Garfin, Steve R. Wang, Jeffrey C. |
author_facet | Agarwal, Aakash Schultz, Christian Goel, Vijay K. Agarwal, Anand Anand, Neel Garfin, Steve R. Wang, Jeffrey C. |
author_sort | Agarwal, Aakash |
collection | PubMed |
description | STUDY DESIGN: A literature review. OBJECTIVES: An evaluation of the contaminants prevalent on implants used for surgery and the aseptic methods being employed against them. METHODS: PubMed was searched for articles published between 2000 and 2017 for studies evaluating the contaminants present on spine implants, and associated pre- and intraoperative implant processing and handling methodology suggested to avoid them. Systematic reviews, observational studies, bench-top studies, and expert opinions were included. RESULTS: Eleven studies were identified whose major focus was the asepsis of implants to reduce the incidence of surgical site infection incidences during surgery. These studies measured the colony forming units of bacteria on sterilized implants and/or gloves from the surgeon, scrub nurse, and assistants, as well as reductions of surgical site infection rates in spine surgery due to changes in implant handling techniques. Additionally, the search included assessments of endotoxins and carbohydrates present on reprocessed implants. The suggested changes to surgical practice based on these studies included handling implants with only fresh gloves, keeping implants covered until the immediate time of use, reducing operating room traffic, avoiding reprocessing of implants (ie, providing terminally sterilized implants), and avoiding touching the implants altogether. CONCLUSIONS: Both reprocessing (preoperative) and handling (intraoperative) of implants seem to lead to contamination of sterilized implants. Using a terminally sterilized device may mitigate reprocessing (preoperative implant prophylaxis), whereas the use of fresh gloves for handling each implant and/or a permanent shielding technique (intraoperative implant prophylaxis) could potentially avoid recontamination at the theatre. |
format | Online Article Text |
id | pubmed-6232723 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-62327232018-11-15 Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine Surgery Agarwal, Aakash Schultz, Christian Goel, Vijay K. Agarwal, Anand Anand, Neel Garfin, Steve R. Wang, Jeffrey C. Global Spine J Review Articles STUDY DESIGN: A literature review. OBJECTIVES: An evaluation of the contaminants prevalent on implants used for surgery and the aseptic methods being employed against them. METHODS: PubMed was searched for articles published between 2000 and 2017 for studies evaluating the contaminants present on spine implants, and associated pre- and intraoperative implant processing and handling methodology suggested to avoid them. Systematic reviews, observational studies, bench-top studies, and expert opinions were included. RESULTS: Eleven studies were identified whose major focus was the asepsis of implants to reduce the incidence of surgical site infection incidences during surgery. These studies measured the colony forming units of bacteria on sterilized implants and/or gloves from the surgeon, scrub nurse, and assistants, as well as reductions of surgical site infection rates in spine surgery due to changes in implant handling techniques. Additionally, the search included assessments of endotoxins and carbohydrates present on reprocessed implants. The suggested changes to surgical practice based on these studies included handling implants with only fresh gloves, keeping implants covered until the immediate time of use, reducing operating room traffic, avoiding reprocessing of implants (ie, providing terminally sterilized implants), and avoiding touching the implants altogether. CONCLUSIONS: Both reprocessing (preoperative) and handling (intraoperative) of implants seem to lead to contamination of sterilized implants. Using a terminally sterilized device may mitigate reprocessing (preoperative implant prophylaxis), whereas the use of fresh gloves for handling each implant and/or a permanent shielding technique (intraoperative implant prophylaxis) could potentially avoid recontamination at the theatre. SAGE Publications 2018-04-24 2018-10 /pmc/articles/PMC6232723/ /pubmed/30443488 http://dx.doi.org/10.1177/2192568218762380 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Review Articles Agarwal, Aakash Schultz, Christian Goel, Vijay K. Agarwal, Anand Anand, Neel Garfin, Steve R. Wang, Jeffrey C. Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine Surgery |
title | Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine
Surgery |
title_full | Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine
Surgery |
title_fullStr | Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine
Surgery |
title_full_unstemmed | Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine
Surgery |
title_short | Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine
Surgery |
title_sort | implant prophylaxis: the next best practice toward asepsis in spine
surgery |
topic | Review Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232723/ https://www.ncbi.nlm.nih.gov/pubmed/30443488 http://dx.doi.org/10.1177/2192568218762380 |
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