Abstract
POST-STERILIZATION CONTAMINATION BY HANDLING FORCEPS IN KHARTOUM BAHRI TEACHING HOSPITAL ORTHOPEDIC THEATER FROM FEBRUARY TO MAY 2016

Sakher Alssayed Mohamed Ahmed*, Azer Abbas, Hozifa Mohammed Ali Abd_Elmaged, Ibrahim Salih Elkheir Attia, Areeg Dawoud Hussien Dawoud, Gaise Yousif Mohammed Jahelrasoul, Mudathir A. A. Abakar and Zeinab O. S. Mohammed

ABSTRACT

Surgical site infections (SSIs) are defined as infections occurring up to 30 days after surgery (or up to one year after surgery in patients receiving implants) and affecting either the incision or deep tissue at the operation site.[1] are the most common nosocomial infections[2] & in particular are the most popular perioperative complications.[3] It lead to adverse patient outcomes, including prolonged hospitalization and death.[4] Strategies to prevent these infections are crucial. Evidence based measures like hand hygiene, treatment of nasal carriage of S. Aureus, surveillance, prophylactic application of antibiotics or hair removal with electric clippers are listed in national and international guidelines.[3,4] A nosocomial infection is determined by plenty of factors, such as a kind of flora and its virulence, hygiene standard, technical terms of work organization in hospital, staff and patient related factors[5,6,7] efficacy of material and instruments sterilization.[5,8,9,10,11,12] Surgical tools including knives & Surgical power tools, & splash basin my represent a contamination source.[13,14,15,16,17] Failure to administer the first dose of antimicrobial prophylaxis within the 2-h window of time before incision is associated with 2- to 6-fold increases in rates of surgical site infection.[18] The incidence of SSIs it range from 1.4 to 3.3 (2.35).[19,13,21,22,23] The incidence of SSIs may be as high as 20%, depending on the surgical procedure (1) in children over 24 months of age who underwent surgical implant procedures and had longer preoperative periods and lengths of hospitalization.[22] All surgical operations have the potential for contamination, and the equipment used can harbor bacteria.[24, 25,26,27] These showed rates of contamination of 11.4% for the sucker tips, 14.5% for light handles, 9.4% for skin blades and 3.2% for the inside blades used during surgery; 28.7% of gloves used for preparation were also contaminated. Of the samples taken from the collection bags used during hip arthroplasty, 20% grew bacteria, which represents a significant microbial reservoir. Also, 17% of theatre gowns were contaminated at the end of the operation.[24] Hospital infections arise by cross infection from other patients and hospital staff, and by transmission of pathogens from items in the hospital environment including hospital bed handsets, children's toys, sinks, door handles, patient files and flowers.[28,29,30,31,32] Organisms may be transmitted by direct and indirect contact, by the airborne route, and with water, food and drugs.[30] The most common infective organism was Staphylococcus species including Methicillin Resistant Staphylococcus Aureus (MRSA). Acinetobacter species, Pseudomonas species, and Escherichia coli.[1,23,33,34,35]

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