Reusable Tourniquets as Potential Risk of Microbial Transmission - Comparison of Operating Theatre and Emergency Department

The cross-sectional study was conducted in the operating theater and emergency department of a tertiary referral hospital in Gdansk, Poland, in three part from March to April 2024. The study included reusable tourniquets used by the hospital's medical staff during vascular access generation.

After each stage of the in-hospital study, the stasis was collected and replaced with new ones. A total of 53 reusable stasis were collected in three phases of the study and were subjected to microbiological analysis at the Department of Immunobiology and Environmental Microbiology of the Medical University of Gdansk. The tourniquets were collected into disposable, sterile bags. In the first stage of the study, tourniquets were collected of indefinite use (n= 17). In the second and third stages of the study, stasis used for 14 (n=20) and 28 (n=16) days, respectively, were collected. All tourniquets were labeled and assigned to different rooms located within the surveyed wards. The trial was conducted separately, for the plastic fastener and the fabric band. The plastic parts of the tourniquets were placed in sterile glass dishes. Under laboratory conditions, the plastic parts of the stasis were cut off and placed in the dishes. Using sterile swabs soaked in 0.9% sodium chloride, the plastic was swabbed, after which the tip of the swab was cut off, placed in a tube with 0.9% sodium chloride (3ml), which was shaken in a Vortex device (30 seconds) and the obtained material was seeded on columbia Agar with 5% sheep blood. The material part of the stasis was placed in a sterile homogenization bag with the addition of 100ml of nutrient broth. The bag was then placed in a Stomacher Homogenizer for two minutes to detach the microorganisms from the porous surface of the material. The resulting homogenate was transferred in a concentrated state and diluted tenfold using 200 μl pipettes onto columbia Agar media supplemented with 5% sheep blood.200 μl of concentrated homogenate was seeded onto the quality growth media MacConkey Broth, King B Agar, CHROMagar E. coli and other coliforms. The protected material was incubated for 24 hours at 37°C, in an aerobic atmosphere. After this time, bacterial colonies were counted and counts were performed to determine the number of microorganisms on the surface of the stasis (CFU/cm2). Due to the assumptions of the experiment and the time frame, eight tourniquets were not included in the analysis. From the information obtained from the medical staff, this was due to significant soiling, making it impossible to use the tourniquets, and in a few cases the plastic fastener broke.