The so-called “five-second rule” has been debunked in food safety, yet a similar mindset persists in surgical environments. Implant drops are not uncommon with 61.5% occurring during emergency procedures. Despite the frequency, guidelines for managing dropped implants have not been established.
Studies of operating room (OR) contamination consistently demonstrate that surfaces, including floors, are frequently colonized by pathogens, making any dropped item, particularly an implant, potentially dangerous. Data from Weber et al, among others, underscore the real risk posed by contaminated OR environments.
A 2019 literature review by Vautrin et al examined expert responses to dropped polyethylene (PE) implants and found that more than half of experienced orthopedic surgeons would prefer to delay definitive implantation rather than use a contaminated liner, underscoring that replacement is generally favored when feasible. However, other strategies included soaking the implant in antiseptic solutions or temporarily using a provisional implant.
This study was designed to simulate a real-world scenario and assess the efficacy of 3 disinfectants on PE liners dropped on OR floors. The primary objective was to compare bacterial contamination counts before and after immersion in sterile preparations of chlorhexidine-alcohol (CHG), povidone-iodine (PI), or ethanol (EtOH).