34th Annual Scientific Meeting proceedings

Introduction
Surgical site infection is a significant post-operative complication. Our objective was to compare the efficacy of four draping protocols during cadaver tenoscopy of the digital flexor tendon sheath (DFTS).

Materials and methods
Fifty-six cadaver distal limbs were randomly assigned to one of four groups (n=14). Draping protocols were; cohesive wrap only (Group 1), the addition of a sterile glove over the hoof (Group 2); the addition of an impervious drape (Group 3) and the addition of an adhesive drape (Group 4). Limbs were inoculated using a standardised bacterial broth prior to aseptic preparation. The DFTS was approached tenoscopically and lavaged with 5 litres of sterile saline. Bacteriology culturettes were obtained prior to aseptic preparation, following draping and then 20 minute intervals for 60 minutes. Absolute counts of colony-forming units were performed after 24-and 48-hour periods of incubation.  Statistical analysis was performed and a p value of <0.05 was considered significant.

Results
Aseptic preparation resulted in no bacterial growth in all limbs. Post-draping sampling identified bacterial growth in all limbs with no significant difference between groups. Bacterial contamination increased over time in group 1 (P<0.01) however there was no significant difference in other groups.

Discussion/Conclusions
This study demonstrated the importance of aseptic preparation in reducing bacterial contamination prior to orthopaedic surgery. Where an impervious layer is not used, bacterial contamination of the surgical site increases over time. Including the hoof in aseptic preparation may further reduce contamination risk. Limitations include small sample size and lack of a true surgical procedure.