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O2283 IS THERE A RATIONALE FOR USING A SKIN KNIFE?



Abstract

Aims: The aim of this study was to reassess whether the use of a Ôone knife techniqueñ can be considered as safe as the current practice of using separate skin and inside knives for elective orthopaedic surgery. Methods: A tatal of 609 knife blades from 203 elective orthopaedic operations consisting of equal numbers of skin, inside and control blades, were cultured using direct and enrichment media. Results: Thirty-one skin blades (15.3%), 22 inside blades (10.8%) and 13 control blades (6.4%) gave bacterial growth. In only 3 cases (1.4%) skin and inside knife cultures grew corresponding organisms. However, in the presence of skin knife contamination the same organism was found on 10% of inside blades. It remains to be seen whether in the remaining 90% contamination of deeper layers was prevented by changing the knife after the skin incision, since the incidence of late deep sepsis is not yet known in these cases. Conclusions: The organisms cultured in this study were predominantly coagulase-negative staphylococci, known to be major culprits in early and late peripros-thetic infection. Our study suggests that the rationale for separate skin and inside knives can be supported, since the cost of a single deep infection in human and þnancial terms can be considerable

Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.