Immediate-use steam sterilization may not increase infection rates in orthopedic surgery

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April 20, 2022

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Disclosures: Tantillo does not report any relevant financial information. Please see the study for relevant financial information from all other authors.


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Immediate-use steam sterilization during orthopedic surgery may not increase rates of surgical site infection in patients, according to published results.

“Through our propensity score study, we found that when immediate-use steam sterilization [IUSS] is used during an orthopedic procedure, there is no statistically increased risk of developing a surgical site infection [SSI]”, Tyler J. Tantillo, DO, said Healio.

Among 70,600 patients who underwent total knee or hip replacement surgery, laminectomy, or spinal fusion from January 2014 to December 2020, Tantillo and colleagues identified 3,526 patients who had used the IUSS during surgery. The researchers performed a matched propensity score analysis to account for known predictors of SSI, which included a total of 7,052 patients. The researchers compared the risk of SSI among patients whose procedure was performed and those who did not include the IUSS with the risk difference, relative risk, odds ratio and McNemar’s test.

Tyler J. Tantillo

Tyler J. Tantillo

Results showed that 111 of 7052 matched patients developed SSI after propensity score matching. The researchers found that 54.95% of the 111 patients had an IUSS during surgery and 45.05% of the patients did not. Patients in the non-IUSS group had an estimated 1.42% chance of developing SSI compared with 1.73% of patients in the IUSS group, according to the results. The researchers found no evidence that the proportion of SSI was higher in the IUSS group.

“Unlike previous studies citing an increased risk of SSI with the use of the IUSS, our study shows that the IUSS can be performed safely during an orthopedic procedure,” Tantillo said. “While we recognize that the results of our study may not change policy immediately, and that future prospective studies are warranted, we encourage policy makers to reconsider the utility of the IUSS in minimizing surgical delays, as well as costs and waste.

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