Examination of fluoroscopy monitor as a source of indirect bacterial contamination in orthopaedic surgery

Abstract

Background: Surgical site infection is a well-documented complication of surgery. While contact with fomites represents a recognised source of contamination, electrostatic charge can cause contamination without surface contact as shown in previous studies evaluating operating room equipment. In cases requiring fluoroscopy, an intraoperative X-ray method, it is common for a surgeon to point to the associated monitor, particularly when teaching. This close proximity without direct contact poses a theoretical risk of contamination due to potential electrostatic forces. Aim/Objective: To assess whether a gloved finger could be contaminated by a fluoroscopy monitor without direct contact. Methods: Using a laser-guided level, a sterile, gloved finger was traversed side-to-side, top-to-bottom, across a fluoroscopy monitor used during surgery at distances of 1 cm, 2 cm, 4 cm and 8 cm. Two negative controls and a positive control were collected for comparison. Specimens were inoculated onto agar plates and incubated for 48 h at 37 °C. Following incubation, samples were analysed for growth and the number of colonies was recorded. This was repeated during 10 randomly selected operative cases using fluoroscopy for a total of 70 samples. Results: No bacterial growth was identified as a result of inoculation on any of the 70 experimental or control specimens. Discussion: We conclude that the practice of pointing to a fluoroscopy monitor for educational or other purposes is unlikely to increase the risk of glove contamination.