Iordningställande av steril kirurgisk utrustning inför ortopedisk implantatkirurgi – Följs hygienrutiner?

Abstract

Background: Post-sterilization contamination of surgical instruments in orthopedic surgery increases the risk of postoperative infections. Adherence to hygiene routines is crucial to minimize this risk. Research question: How well are hygiene protocols followed during the preparation and protection of sterile surgical equipment prior to orthopedic implant surgery? Does adherence to protocols regarding equipment protection and the number of door openings differ between prosthetic surgery and other types of orthopedic implant surgery (e.g., plates, screws, and intramedullary nails)? Materials and Methods: This observational, quantitative study involved systematic data collection using an observation protocol. Surgical teams were observed during the preoperative preparation of sterile equipment. Two categories were studied: prosthetic surgery (n = 22) and other implant surgery (n = 25). Data were analyzed descriptively. Results: High adherence was observed for surgical attire, masks, and head coverings. However, significant variation occurred in the protection of sterile equipment. Compliance with sterile draping was lower in other implant surgery 20% (n = 5) compared to prosthetic surgery 59% (n = 13) (p < 0.05). Preparing equipment with closed doors was followed in 50% (n = 11) of prosthetic and 48% (n = 12) of other implant surgeries. The median number of door openings was 0.5 for prosthetic surgery and 1.0 for other implant surgery, with no significant difference (p = 0.53). Conclusions and Implications: The study identified variations in hygiene routine adherence, particularly in protecting sterile equipment, depending on surgery type. These findings suggest a need for targeted interventions to standardize practices and maintain equipment sterility. Non-compliance with minimizing door openings during preparation remains a concern for patient safety. Further research is necessary to explore contributing factors and improve compliance.