Operating theatre exsanguinators pose a low risk for transmission of infection

There is increasing concern regarding transmission of infection in hospitals. The cost of a hospital-acquired infections can run into several thousands of pounds per patient [1]. We regularly use Esmarch bandages and black rubber Rhys exsanguinators, which are applied prior to tourniquet inflation for orthopaedic and plastic surgery procedures. An open wound is wrapped in plastic bags prior to placement of the exsanguinator. It became apparent that as these exsanguinators were used on repeated patients and cleaned between by washing with a Hibiscrub solution, they may be a source of infection. We decided to send swabs from all seven of our exsanguinators to microbiology for routine culture.

All four Esmarch bandages showed no bacterial growth. One out of our three Rhys exsanguinators grew a coagulase-negative staphylococcus. This is a non-pathogenic skin commensal. Obviously, our numbers are small, but the low incidence of positive culture was reassuring. However, the growth from the black rubber exsanguinator may be due to the fact that it is more difficult to clean adequately, and shows that there is no room for complacency in the cleaning of such pieces of equipment