Eltiam

Eltiam

Preparation of the surgical team

Document Type : Review article

Authors
Nahid Sadeghpour 1
Amirhossein Bayati 2
Arash Rashidi
Saman Imanzadeh
sh m
m s
p m
a n
1 Midwifery department, Urmia branch, Islamic Azad University, Urmia, Iran.
2 Department of clinical sciences, Urmia branch, Islamic Azad University, Urmia, Iran
10.61186/eltiamj.11.1.37
Abstract
Background: A review of the preparation of the surgical team
Objectives: Explain the preparation of the surgical team
Methods: A literature review using various publications related to the preparation of the surgical team
Results: Surgical site infection is one of the most common cases and complications after a surgical procedure, which causes a lot of costs for the patient and the medical centers. Preparing the surgeon's hands is always one of the most important strategies to reduce surgical site infections and one of the most important medical procedures. The risk of surgical site infection arises not only from contact with the patient's natural flora, but also from the unintentional transmission of microorganisms from surgeons and operating room staff to the patient. Operating room personnel are one of the main factors that increase bacterial contamination of the surgical site. Sterile gloves are worn in the operating room as a primary barrier against such transmission. Although the prevalence of surgical site infections is attributed to organisms in the hair or on the scalp, no systematic study has been conducted to measure the number of bacteria in the environment when a head mask is worn or not, and there is no accurate information on whether it is effective or not. The use of a face mask during surgery does not have a significant effect on surgical site infection, but it does reduce the spread of bacteria in the operating room. It has been shown that increased foot traffic through the operating room has been demonstrated to increase ambient microbial levels and ensuing infection risk. Preparation of the surgeon's hand and forearm before entering the operating room plays an important role in reducing the rate of surgical site infections. Surgical gowns form a barrier between the surgical site and the skin of the surgical team, which is one of the most important factors in reducing infections in the surgical site.
Conclusions: Preparation of the surgical team is considered one of the most important methods of preventing surgical site infection, and all members of the surgical team must perform all the necessary measures.
Keywords
Surgical site infection
Scrub
Surgical team
Hand/Arm scrub
1.       Thrusfield, M., 2018. Veterinary Epidemiology. 1.Scott RD. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention. 2009. https://pubmed.ncbi.nlm.nih.gov/10196487
2.       Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Committee HICPA. Guideline for prevention of surgical site infection, 1999. Infection Control & Hospital Epidemiology. 1999;20(4):247-80. https://doi.org/10.1086/501620 
3.      Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999;27(2):97-132; quiz 3-4; discussion 96. https://doi.org/10.1086/501620
4.       Lister J. On the antiseptic principle in the practice of surgery. British medical journal. 1867;2(351):246. https://doi.org/10.1136/bmj.2.351.246
5.       Widmer AF, Rotter M, Voss A, Nthumba P, Allegranzi B, Boyce J, Pittet D. Surgical hand preparation: state-of-the-art. Journal of Hospital Infection. 2010;74(2):112-22. https://doi.org/10.1016/j.jhin.2009.06.020 
6.       Thomas M, Hollins M. EPIDEMIC OF POSTOPERATIVE WOUND INFECTION ASSOCIATED WITH UNGLOVED ABDOMINAL PALPATION. The Lancet. 1974;303(7868):1215-7. https://doi.org/10.1016/s0140-6736(74)91019-8 
7.       Kampf G, Goroncy-Bermes P, Fraise A, Rotter M. Terminology in surgical hand disinfection—a new Tower of Babel in infection control. Journal of Hospital Infection. 2005;59(3):269-71. https://doi.org/10.1016/j.jhin.2004.09.020 
8.       Charnley J, Eftekhar N. Postoperative infection in total prosthetic replacement arthroplasty of the hip-joint with special reference to the bacterial content of the air of the operating room. Journal of British Surgery. 1969;56(9):641-9. https://doi.org/10.1002/bjs.1800560902 
9.       Jackson J. Father of the modern hip replacement: Professor Sir John Charnley (1911–82). Journal of medical biography. 2011;19(4):151-6. https://doi.org/10.1258/jmb.2011.011021 
10.    Tracy DL. Small animal surgical nursing: Mosby Inc.; 2000. 105-25 p.
11.    Mastro TD, Farley TA, Elliott JA, Facklam RR, Perks JR, Hadler JL, et al. An outbreak of surgical-wound infections due to group A streptococcus carried on the scalp. New England Journal of Medicine. 1990;323(14):968-72. https://doi.org/10.1056/nejm199010043231406 
12.    Owers KL, James E, Bannister G. Source of bacterial shedding in laminar flow theatres. Journal of hospital infection. 2004;58(3):230-2. https://doi.org/10.1016/j.jhin.2004.06.028 
13.    Reichman DE, Greenberg JA. Reducing surgical site infections: a review. Rev Obstet Gynecol. 2009;2(4):212-21. https://pmc.ncbi.nlm.nih.gov/articles/PMC2812878
14.    Weaver GH. Droplet infection and its prevention by the face mask. The Journal of Infectious Diseases. 1919:218-30. https://doi.org/10.1093/infdis/24.3.218 
15.   McLure H, Talboys C, Yentis S, Azadian B. Surgical face masks and downward dispersal of bacteria. Anaesthesia. 1998;53(7):624-6. https://doi.org/10.1046/j.1365-2044.1998.435-az0528.x 
16.    Ritter MA, Eitzen H, French ML, Hart JB. The operating room environment as affected by people and the surgical face mask. Clinical Orthopaedics and Related Research (1976-2007). 1975;111:147-50. https://doi.org/10.1097/00003086-197509000-00020 
17.    Centers for Disease C. Nosocomial outbreak of Rhizopus infections associated with Elastoplast wound dressings-Minnesota. MMWR. 1978;27:33-4. https://doi.org/10.3928/0147-7447-19790701-10 
18.    Richet HM, Craven PC, Brown JM, Lasker BA, Cox CD, McNeil MM, et al. A cluster of Rhodococcus (Gordona) Bronchialis sternal-wound infections after coronary-artery bypass surgery. N Engl J Med. 1991;324(2):104-9. https://doi.org/10.1056/nejm199101103240206 
19.    Wenger PN, Brown JM, McNeil MM, Jarvis WR. Nocardia farcinica sternotomy site infections in patients following open heart surgery. J Infect Dis. 1998;178(5):1539-43. https://doi.org/10.1086/314450 
20.    Bassett DC, Stokes KJ, Thomas WR. Wound infection with Pseudomonas multivorans. A water-borne contaminant of disinfectant solutions. Lancet. 1970;1(7658):1188-91. https://doi.org/10.1016/s0140-6736(70)91783-6 
21.    Auer JA, Stick JA. Equine Surgery-E-book: Elsevier Health Sciences; 2018 ..21
22.    Johnston SA, Tobias KM. Veterinary Surgery: Small Animal Expert Consult-E-Book: 2-Volume Set: Elsevier Health Sciences; 2017.
23.    Watanabe A, Kohnoe S, Shimabukuro R, Yamanaka T, Iso Y, Baba H, et al. Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery. Surg Today. 2008;38(5):404-12. https://doi.org/10.1007/s00595-007-3637-y 
24.    Urban JA. Cost analysis of surgical site infections. Surg Infect (Larchmt). 2006;7 Suppl 1:S19-22. https://doi.org/10.1089/sur.2006.7.s1-19 
25.    Vegas AA, Jodra VM, García ML. Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol. 1993;9(5):504-10. https://doi.org/10.1007/bf00209528 
26.    de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009;37(5):387-97. https://doi.org/10.1016/j.ajic.2008.12.010 
27.    Broex EC, van Asselt AD, Bruggeman CA, van Tiel FH. Surgical site infections: how high are the costs? J Hosp Infect. 2009;72(3):193-201. https://doi.org/10.1016/j.jhin.2009.04.012 
28.    Altemeier WA, Culbertson WR, Hummel RP. Surgical considerations of endogenous infections--sources, types, and methods of control. Surg Clin North Am. 1968;48(1):227-40.https://doi.org/10.1016/s0039-6109(16)38448-1 
29.    Wiley AM, Ha'eri GB. Routes of infection. A study of using "tracer particles" in the orthopedic operating room. Clin Orthop Relat Res. 1979(139):150-5. https://doi.org/10.1097/00003086-197903000-00025 
30.    Schaberg DR. Resistant gram-positive organisms. Ann Emerg Med. 1994;24(3):462-4.  https://doi.org/10.1016/s0196-0644(94)70185-7 
31.    Schaberg DR, Culver DH, Gaynes RP. Major trends in the microbial etiology of nosocomial infection. Am J Med. 1991;91(3b):72s-5s. https://doi.org/10.1016/0002-9343(91)90346-y 
32.    Giamarellou H, Antoniadou A. Epidemiology, diagnosis, and therapy of fungal infections in surgery. Infect Control Hosp Epidemiol. 1996;17(8):558-64. https://doi.org/10.1086/647373 .
Eltiam
Volume 11, Issue 1
April 2024
Pages 37-47

  • Receive Date 12 April 2025
  • Publish Date 20 March 2024