Intestinal bacterial contamination of surgical instruments used for wound closure during intestinal surgery

Abstract

A surgical site infection (SSI) is defined by the Centers for Disease Control and Prevention (CDC) as an infection occurring at the operative site within specific time frames, depending on the nature of the surgical procedure. SSI incidence differs among surgeries, and intestinal surgery is one of those with a high SSI incidence. In Japan, from 2008 to 2010, SSI incidence rates for colon and rectal surgery were 15.0 and 17.8 per cent, respectively. SSI results in prolonged hospital stays and additional medical expenses. Therefore, SSI prevention is
particularly important for improving patient outcomes.

Perioperative surgical site contamination with endogenous or exogenous bacteria is the main cause of SSI, explaining why the SSI incidence in intestinal surgery is higher than in other surgeries. Although the most common bacteria that cause SSI live on skin, such as Staphylococcus aureus and coagulase-negative staphylococci (CNS), bacteria of intestinal origin, such as Enterococcus species, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, K. oxytoca and Acinetobacter species, have also been isolated from SSIs
developed after intestinal surgeries. Surgical incision and operating site contamination with intestinal bacteria is a particularly problematic issue during intestinal surgery.

In this study, we aimed to evaluate the degree and nature of contamination of surgical instruments used for wound closure during intestinal surgery and to validate the relationship between surgical features and surgical staff member’s years of experience.