Increased risk of time-dependent K-wire and wound contamination and the effect of covering on K-wire contamination: A randomized controlled trial

Abstract

Aim: This was a prospective randomized controlled study to evaluate the time-dependent incidence of contamination of K-wires and wounds in patients who underwent osteosynthesis and the effect of covering the K-wires on this incidence rate of infection.

Materials and Methods: The study sample included 90 patients who underwent open reduction and internal fixation between 2018 and 2019. Patients were randomized to two groups: use of covered K-wires during surgery (using a sterile towel) and use of uncovered K-wires. Bacterial samples were obtained from the K-wires and wound at the following time points: 0 (just after opening of the K-wire packages) and at 15, 30, 60, 90, and 120 min after. Samples with bacterial growth at 48 h were considered contaminated. Microscopic, staining, and biochemical properties were used for bacterial typing.

Results Bacterial growth was detected at the 30- and 60-min time points for the uncovered and covered groups, respectively. Wound contamination was identified within 15 min for the uncovered group. Wound and K-wire contamination progressed as a function of time, being consistently more significant in the uncovered group (p<0.005).

Conclusions: Time-dependent K-wire and wound contamination rates may be decreased by covering the K-wires (and other instruments) with a sterile towel. Frequent wound irrigation during surgery and postoperative prophylactic antibiotics targeting the bacteria we identified might further be useful in lowering the incidence rate of infection.