Duration of time to microbial colonization on surgical instruments and surgical sites intraoperatively at a Public Referral Hospital Kenya

Abstract

Background: Surgical site infections have the highest frequency of postsurgical complications and an impact on health  or illness process of the patient. The absolute sterility of surgical instruments is often assumed. Though other surgicals  are usually changed and the surgical instruments are rarely or not changed hence high chances of surgical wounds  contamination. There are no guidelines on how long instruments be exposed to the open environment before the  contamination risk becomes unacceptable.

Materials and Methods: Analytical cross-sectional design. The study subjects  were 93 surgical patients pre and post wound swabs and instruments swabs hourly x5. Check lists and laboratory forms  were used for data collection. Sample size was 651 (93x7). SPSS used to analyze descriptive statistics and Kaplan-Meier  estimation for survival analysis.

Results: 51.6%; N=48 instruments were colonized by micro-organisms intraoperatively.  75% of the instruments survived microbial colonization at zero minutes. Pre-surgery 11.8% and post-surgery 31.2%  surgical sites had microbial colonization. The cumulative incidence of microbial colonization was 269 per 1000 patients. The mean survival time for the microbial colonization was 230 Minutes 95%CI: 192 to 269 and the median time was 240  minutes. The median time for a surgical site to get microbial colonization was 351 minutes 95%CI: 301 to 401.

Conclusion:  Enhance instrument sterilization, social wash of surgical sites before prepping and microbial  colonization occurs by 4 hours.