P005: BREAK SCRUB TO TAKE THAT PHONE CALL?
Abigail Schirmer, Courtney Swan, BS, Steven Hughes, MD, Terrie Vasilopoulos, PhD, Monika Oli, PhD, Sana Chaudhry, Nikolaus Gravenstein, MD, Chris Giordano, MD; University of Florida
INTRODUCTION: The American College of Surgeons reports that most surgical site infections are preventable. The practice of surgeons taking phone calls while remaining sterile in the operating field is often accomplished by interposing a sterile disposable towel between the phone and their glove. After completing the call, surgeons resume operating. The purpose of our study is to test whether bacteria transmit from an inanimate object, such as a telephone, to the gloves of a surgeon through a sterile disposable towel.
METHODS: A three part study assessed the qualitative and quantitative components of bacterial transmission through sterile disposable OR towels.
1) Samples were collected for culture from four operating room telephones. PCR was performed to determine bacterial species present.
2) GloGerm™, an UV-light enhanced particle powder sized to mimic bacteria, was placed upon an inanimate surface and held with a sterile disposable OR towel covering a sterile surgical glove for 30 seconds. The glove was then inspected for GloGerm™ using a UV light.
3) 18 operating room telephones were cultured, and then held with a Sterile Disposable OR towel (Medline Industries Inc., Northfield, IL) covering a sterile surgical glove for 30 seconds. The surgical gloves were then cultured onto a TSA Agar plate to determine if bacteria had transmitted through the towel and onto the glove.
RESULTS: On 3 of the 4 operating room telephones cultured, Micrococcus luteus, Staphylococcus epidermidis, Microbacterium insulae, Actiniomyces, Staphylococcus pasteuri, and an unclassified species were found. The GloGerm™ powder readily transmitted through the towel to the gloves. Median CFU on the cultured telephones for the 17 samples was 10, ranging from 1 to 35 CFUs. Of these 17 samples, 47% had transmission from the telephone to the glove, which was significantly greater than 0% (95% CI: 26%-69%, p< 0.001).
DISCUSSION: In this conceptual study, we demonstrated that Sterile Disposable Surgical OR Towels, often used by to hold or adjust a non-sterile object within a sterile field, are an ineffective barrier for maintaining surgical sterility. Our first qualitative experiment supports the concern that inanimate objects such as operating room telephones harbor bacteria. Subsequently, the GloGerm™ powder elucidated the porosity of the towels. Finally, we showed that dry sterile gloves became readily contaminated with bacteria when using towels to hold operating room telephones.
CONCLUSION: Sterile disposable OR towels do not provide an effective barrier between bacteria present on operating room telephones and otherwise sterile gloves.