Is it safe to use surgical instruments with debris from a previous surgery after sterilization?
5 affiliations
- 1'Sir John Charnley' Hip Surgery Unit, Institute of Orthopaedics 'Carlos E. Ottolenghi', Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
- 2Instituto de Investigación en Medicina y Ciencias de la Salud, Universidad del Salvador, Buenos Aires, Argentina.
- 3Emeritus Professor of Medical and Environmental Microbiology, Universidad del Salvador, Buenos Aires, Argentina.
- 4Critical Care Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
- 5Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Abstract
Aims
The presence of biological debris on surgical instruments after reprocessing poses potential risks of infection in orthopaedic surgery. While autoclave sterilization is the standard method, its effectiveness in eliminating microbial contamination from residual bone, cement, and fatty tissue remains insufficiently studied. The primary objective was to study in vitro the sterility of retained cement, bone, and fat tissue debris on surgical instruments after autoclave sterilization. The secondary objective was to compare, based on colony-forming units (CFU), which material exhibits greater biofilm formation.Methods
An in vitro study was conducted to evaluate the sterility of retained biological debris on surgical instruments after autoclave sterilization. The autoclave sterilization procedure was performed at 1 atmosphere pressure (121°C) for 20 minutes. A total of 350 repetitions were performed, including five instruments used as sample specimens (drill bit, cannulated flexible reamer, femoral broach, cannulated screwdriver, and wire passer), with 70 repetitions per specimen. CFU/mL were counted and biofilm morphology was assessed through scanning electron microscopy (SEM).Results
After autoclave sterilization, no positive cultures were detected in any of the 350 repetitions (0%, 95% CI 0 to 5; n = 0), demonstrating complete absence of viable microorganisms. Due to the lack of microbial recovery, no statistical comparisons between instrument types were performed. We did not find any structural deformity in the mixed biofilms on bone, cement, and stainless steel as observed by SEM.Conclusion
Autoclave sterilization was effective in eliminating microorganisms from surgical instruments with retained biological debris. Although no apparent structural deformities of microorganisms were observed by SEM in the mixed biofilms, no bacterial growth was detected after sterilization, supporting the microbiological effectiveness of autoclave sterilization even in the presence of retained biological debris. These findings provide microbiological evidence supporting current sterilization practices, and highlight the need for further studies evaluating alternative sterilization methods such as ethylene oxide or plasma.
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BibTeX
@article{semeshchenko2026safe,
title = {{Is it safe to use surgical instruments with debris from a previous surgery after sterilization?}},
author = {Daniyil Semeshchenko and Alicia Farinati and Iván Alfredo Huespe and HIBA Hip Surgery Unit and Jesica Iviglia and Martin Alejandro Buttaro and Pablo Ariel Slullitel and Fernando Comba and Gerardo Zanotti and Agustín F Albani-Forneris and Carlos M Lucero},
journal = {Bone \& joint research},
year = {2026},
month = oct,
doi = {10.1302/2046-3758.1510.bjr-2026-0010.r1},
url = {https://europepmc.org/article/MED/42852539},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Is it safe to use surgical instruments with debris from a previous surgery after sterilization?
AU - Daniyil Semeshchenko
AU - Alicia Farinati
AU - Iván Alfredo Huespe
AU - HIBA Hip Surgery Unit
AU - Jesica Iviglia
AU - Martin Alejandro Buttaro
AU - Pablo Ariel Slullitel
AU - Fernando Comba
AU - Gerardo Zanotti
AU - Agustín F Albani-Forneris
AU - Carlos M Lucero
PY - 2026
DA - 2026/10/01
JO - Bone & joint research
DO - 10.1302/2046-3758.1510.bjr-2026-0010.r1
UR - https://europepmc.org/article/MED/42852539
AB - Aims The presence of biological debris on surgical instruments after reprocessing poses potential risks of infection in orthopaedic surgery. While autoclave sterilization is the standard method, its effectiveness in eliminating microbial contamination from residual bone, cement, and fatty tissue remains insufficiently studied. The primary objective was to study in vitro the sterility of retained cement, bone, and fat tissue debris on surgical instruments after autoclave sterilization. The secondary objective was to compare, based on colony-forming units (CFU), which material exhibits greater biofilm formation.Methods An in vitro study was conducted to evaluate the sterility of retained biological debris on surgical instruments after autoclave sterilization. The autoclave sterilization procedure was performed at 1 atmosphere pressure (121°C) for 20 minutes. A total of 350 repetitions were performed, including five instruments used as sample specimens (drill bit, cannulated flexible reamer, femoral broach, cannulated screwdriver, and wire passer), with 70 repetitions per specimen. CFU/mL were counted and biofilm morphology was assessed through scanning electron microscopy (SEM).Results After autoclave sterilization, no positive cultures were detected in any of the 350 repetitions (0%, 95% CI 0 to 5; n = 0), demonstrating complete absence of viable microorganisms. Due to the lack of microbial recovery, no statistical comparisons between instrument types were performed. We did not find any structural deformity in the mixed biofilms on bone, cement, and stainless steel as observed by SEM.Conclusion Autoclave sterilization was effective in eliminating microorganisms from surgical instruments with retained biological debris. Although no apparent structural deformities of microorganisms were observed by SEM in the mixed biofilms, no bacterial growth was detected after sterilization, supporting the microbiological effectiveness of autoclave sterilization even in the presence of retained biological debris. These findings provide microbiological evidence supporting current sterilization practices, and highlight the need for further studies evaluating alternative sterilization methods such as ethylene oxide or plasma.
SN - 2046-3758
ER -