S11.7 A PROSPECTIVE STUDY OF THE RE-USE OF BRADFORD SLINGS

Abstract

Introduction: A Bradford sling is a device with which the arm can be held in an elevated position in the trauma or post-op elective setting to reduce swelling. It is marketed as a single use item but in many orthopaedic departments it is used multiple times before being discarded especially in the elective recovery setting. We asked the question ‘are there any microbiological implications to the re-use of Bradford slings?’ In our department Bradford slings were used in recovery for patients who had undergone hand surgery as a day-case. The sling would then cease to be used once it had become mechanically unusable.

Method: The Bradford slings employed in a one-month period by a single consultant working in the day surgery unit of the study hospital were examined. Prior to and following each use agar plates were inoculated by pressing the sling directly onto the plates. Two areas each of 5cm², one in the arm and one in the forearm section of the slings were defined and labeled proximal and distal. Aseptic technique was used to avoid contamination by the investigator but otherwise the slings were treated in the same fashion as usually they would be. Patients were all screened for MRSA and were all negative

Results: In a one-month period 6 slings were used between 2 and 7 times (mean 4) resulting in 96 inoculation events. 89 (92.7%) of these events yielded significant bacterial growth. Most of these colonies were coagulase-negative Staphylococcus or Bacillus, however coliforms were cultured 5 (5.2%) times and Staphylococcus Aureus twice (2%). Also all slings demonstrated bacterial growth immediately after removal of packaging prior to first use. Indeed one sling grew coliforms prior to its first use.

There were no incidences of wound infection at 6-week follow-up.

Conclusion: The re-use of the Bradford sling poses no threat to the elective post-op patient. Most of the organisms isolated were environmental organisms unlikely to cause infection. There would only be a significant risk of infection if a patient had an open wound. Interestingly none of the Bradford slings were sterile prior to use. This study demonstrates that there appears to be minimal risk to the patient in re-using slings, but the numbers in this study are limited and a larger study would be helpful in assessing the risk further.