Register      Login
Healthcare Infection Healthcare Infection Society
Official Journal of the Australasian College for Infection Prevention and Control
RESEARCH ARTICLE

The Rhys-Davies exsanguinator: a potential source of bacteria in orthopaedic operations

Jonathon de Hoog A C and John Mills B
+ Author Affiliations
- Author Affiliations

A Orthopaedic Department, Royal Hobart Hospital, 48 Liverpool St, Hobart, Tasmania 7001, Australia.

B Calvary Hospital Lenah Valley, 49 Augusta Rd, Hobart, Tasmania 7008, Australia.

C Corresponding author. Email: jdehoog1@gmail.com

Healthcare Infection 16(4) 136-138 https://doi.org/10.1071/HI11002
Submitted: 20 January 2011  Accepted: 30 September 2011   Published: 16 January 2012

Abstract

Infection complicating hip and knee joint arthroplasty continues to provide significant morbidity to patients. Sources of infectious pathogens in the operating theatre include theatre personnel and equipment in close contact with the patient. The role of the venous exsanguinator as a potential source of skin contamination was studied over 5 consecutive days in a single centre performing knee arthroplasty and arthroscopy. All samples were positive for common skin organisms. The potential for transfer and contamination of patients with significant pathogens may be present when utilising a venous exsanguinator. The use of a specific cleaning procedure for venous exsanguinators should be applied between each operative case, thereby reducing the transmission of potentially significant pathogens.


References

[1]  Willis-Owen CA, Konyves A, Martin DK. Factors affecting the incidence of infection in hip and knee replacement: an analysis of 5277 cases. J Bone Joint Surg Br 2010; 92-B 1128–33.
Factors affecting the incidence of infection in hip and knee replacement: an analysis of 5277 cases.Crossref | GoogleScholarGoogle Scholar |

[2]  Armstrong RW, Bolding F, Joseph R. Septic arthritis following arthroscopy: clinical syndromes and analysis of risk factors. Arthroscopy 1992; 8 213–23.
Septic arthritis following arthroscopy: clinical syndromes and analysis of risk factors.Crossref | GoogleScholarGoogle Scholar |

[3]  Whitehouse JD, Friedman ND, Kirkland KB, Richardson WJ, Sexton DJ. The impact of surgical site infections following orthopaedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol 2002; 23 183–9.
The impact of surgical site infections following orthopaedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost.Crossref | GoogleScholarGoogle Scholar |

[4]  Dharan S, Pittet D. Environmental controls in operating theatres. J Hosp Infect 2002; 51 79–84.
Environmental controls in operating theatres.Crossref | GoogleScholarGoogle Scholar |

[5]  Tschudin S, Egli-Gany D, Dangel M, Oertli D, Weber W, Frei R, et al. No correlation between skin microbial counts after preoperative skin disinfection and surgical site infections. ESCMID. 20th European congress of clinical microbiology and infectious diseases; 2010 Apr 10–13; Vienna, Austria.

[6]  Ballal MS, Emms N, O’Donoghue M, Redfern TR. Rhys-Davies exsanguinator: a haven for bacteria. J Hand Surg Eur Vol 2007; 32 452–6.
Rhys-Davies exsanguinator: a haven for bacteria.Crossref | GoogleScholarGoogle Scholar |

[7]  Hanssen AD, Osmon DR, Nelson CL. Instructional course lectures, the American Academy of Orthopaedic Surgeons – prevention of deep periprosthetic joint infection. J Bone Joint Surg Am 1996; 78 458–71.

[8]  Abudu A, Sivardeen KA, Grimer RJ, Pynsent PB, Noy M. The outcome of perioperative wound infection after total hip and knee arthroplasty. Int Orthop 2002; 26 40–3.
The outcome of perioperative wound infection after total hip and knee arthroplasty.Crossref | GoogleScholarGoogle Scholar |

[9]  Crossley K, Jefferson K, Archer G, Fowler V, eds. Staphylococci in human disease. 2nd ed. Singapore: Wiley-Blackwell; 2009.

[10]  Brennan SA, Walls RJ, Smyth E, Al Mulla T, O’Byrne JM. Tourniquets and exsanguinators: a potential source of infection in the orthopaedic operating theatre? Acta Orthop 2009; 80 251–5.
Tourniquets and exsanguinators: a potential source of infection in the orthopaedic operating theatre?Crossref | GoogleScholarGoogle Scholar |

[11]  Fletcher N, Sofianos D, Berkes MB, Obremskey WT. Prevention of perioperative infection. J Bone Joint Surg Am 2007; 89 1605–18.
Prevention of perioperative infection.Crossref | GoogleScholarGoogle Scholar |

[12]  Anetic Aid. The Rhys-Davies exsanguinator: User’s guide. Available by request from http://www.aneticaid.co.uk (received by correspondence 23 July 2010)