• H C Sagi, Thomas DiPasquale, Roy Sanders, and Dolfi Herscovici.
• University of California San Francisco, Fresno Medical Education Program, Fresno, California 93702, USA. eversosaggy@cs.com
• J Orthop Trauma. 2002 Nov 1;16(10):696-700.

ObjectivesTo determine if the exhaust from surgical compressed-air power tools contains bacteria and if the exhaust leads to contamination of sterile surfaces.DesignBacteriologic study of orthopaedic power tools.SettingLevel I trauma center operative theater.Patients/ParticipantsNone.InterventionPart I. Exhaust from two sterile compact air drills was sampled directly at the exhaust port. Part II. Exhaust from the drills was directed at sterile agar plates from varying distances. The agar plates represented sterile surfaces within the operative field. Part III. Control cultures. A battery-powered drill was operated over open agar plates in similar fashion as the compressed-air drills. Agar plates left open in the operative theater served as controls to rule out atmospheric contamination. Random cultures were taken from agar plates, gloves, drills, and hoses.Main Outcome MeasurementIncidence of positive cultures.ResultsIn Part I, all filters from both compressed-air drill exhausts were culture negative ( = 0.008). In Part II, the incidence of positive cultures for air drills number one and number two was 73% and 82%, respectively. The most commonly encountered organisms were, coagulase-negative Staphylococcus, and Micrococcus species. All control cultures from agar plates, battery-powered drill, gloves, and hoses were negative ( < 0.01).ConclusionsExhaust from compressed-air power tools in orthopaedic surgery may contribute to the dissemination of bacteria onto the surgical field. We do not recommend the use of compressed-air power tools that do not have a contained exhaust.

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