Aerosols produced by high-speed cutters in cervical spine surgery: extent of environmental contamination

High-speed cutters are used in the surgery of the cervical spine. Such high -speed devices can produce an aerosol cloud. As a patient can be a reservoi r for pathogens, with aerosol-borne paths of transmission, such an aerosol has to be seen as a potential risk of infection for health care professiona ls present during the surgery and for patients if micro-organisms are trans ferred through the medical personnel. The study was performed in order to m easure the extension of environmental and body contamination through contam inated aerosols produced by a high-speed cutter. Three laminectomies (C4-C6 ) were performed on an intact human cadaver with a high-speed 0.6-mm ball c utter. A complete surgical setup was arranged, including surgical draping a nd a barrier drape to the anesthesiologist's workplace. Body and environmen tal contamination was detected by the use of surveillance cultures. The irr igation solution was artificially contaminated with Staphylococcus aureus A TCC 12600. Following the surgery, staphylococci were detected in the operat ing room at an extension of 5x7 m. Everybody showed extensive face and body contamination with Staphylococcus aureus. The study showed that the use of high-speed cutters in surgery of the cervical spine produces an aerosol cl oud that is spread over the whole surgical room and contaminates the theate r and all personnel present. Such aerosols can be contaminated with pathoge ns if the patient was infected or colonized. Therefore, sufficient protecti ve measures have to be recommended for everyone present in the operating ro om during such surgeries. In addition, efficient disinfection of the room a nd all mobile equipment is necessary after each surgery involving high-spee d cutting devices.