The Journal of Bone and Joint Surgery (American). 2005;87:2193-2195.
doi:10.2106/JBJS.E.00293
© 2005 The Journal of Bone and Joint Surgery, Inc.
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Sterility of Surgical Site Marking

Geoffrey Cronen, MD1, Vytautas Ringus, MD1, Gavin Sigle, MS IV1 and Jaiyoung Ryu, MD1

1 Department of Orthopaedics, West Virginia University, P.O. Box 9196, Health Sciences Center, Morgantown, WV 26506-9196. E-mail address for G. Cronen: wvubonehead{at}yahoo.com

Investigation performed at the Department of Orthopaedics, West Virginia University, Morgantown, West Virginia

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).

Background: Over the past decade, wrong-site surgery has been a popular topic of discussion, not only in medical and legal journals but also in the mainstream press. Marking of the surgical site according to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Universal Protocol was implemented at our institution to help reduce the number of wrong-site operations. In this study, we determined whether marking of the site affected the sterility of the surgical field.

Methods: The study included twenty volunteers. The right forearm was used as the experimental (marked) arm and the left forearm, as the control arm. The experimental forearms were marked with a surgical marker as described by the protocol. Both upper extremities were then sterilized from the antecubital fossa to the phalanges with a 7.5% povidone-iodine scrub followed by the application of a 10% povidone-iodine paint. Swabs were used to obtain samples from the experimental and control arms as well as from the marker and were sent for microbiological culture and analysis.

Results: No growth was seen in the cultures of the swabs used on the experimental or control arms or on the marking pens.

Conclusions: Preoperative marking of surgical sites in accordance with the JCAHO Universal Protocol did not affect the sterility of the surgical field, a finding that provides support for the safety of surgical site marking.


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This article has been cited by other articles:


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Letters to the Editor:

Read all Letters to the Editor

IS SURGICAL SITE MARKING REALLY SAFE?
Subramanyam n Maripuri
JBJS Online, 17 Jan 2006 [Full text]
Dr. Cronen responds to Dr. Maripuri
Geoffrey A. Cronen, M.D.
JBJS Online, 11 Apr 2006 [Full text]