X marks the spot: Sharpies get thumbs-up for marking surgery sites

Oct 21, 2008

A bit of good news out of the Faculty of Medicine & Dentistry at the University of Alberta for patients undergoing surgery or an invasive procedure, their surgeons and cost-conscious hospital administrators. It's standard practice for the surgeon or their designate, (in consultation with the patient when possible), to mark the operative/invasive site using a marking pen before an operation, a precaution to ensure surgeons cut the correct spot. But there was concern that germs would be spread from one patient to the next, so it has also become common procedure to throw away the marker each time, costing thousands of dollars a year.

Turns out hospital staff were putting too fine a point on it, say a couple of infection control specialists at the U of A who looked into the matter. Associate professor Dr. Sarah Forgie of the Department of Pediatrics and pediatric infectious diseases resident Dr. Catherine Burton have shown that the tips of the Sharpies® don't spread infection since the ink has an alcohol base.

This has caught the attention of organizers of a major conference on infectious disease taking place in Washington, D.C., at the end of October. They have invited Burton to share her work with other disease control specialists from around the world, an honour for the resident.

After asking around and finding out that many of the surgical teams in Edmonton liked using Sharpie® brand markers, Forgie and Burton decided to put the common, everyday brand to the test along with another brand, the second one a sterile marker specifically intended for single use in operating rooms.

In a controlled experiment, marker tips were heavily contaminated with four types of bacteria that can cause surgical site infections; two of the germ types are of particular concern in hospitals since they are antibiotic-resistant, Burton explained.

After recapping the markers and letting them sit for 24 hours, Burton and Forgie found that the sterile, one-use marker, which has a non-alcohol-base ink, was still contaminated. But the Sharpies® were not.

In collecting an extremely large number of germs on the markers during their experiment, "we went much further than what would happen in real life," said Forgie.

She is confident that the marking tip of Sharpies® does not pose a risk of bacterial transmission. As long as the rest of the pen is cleaned with an alcohol swab between patients (just as is done with stethoscopes), the Sharpies® do not need to be discarded after each use. Safety is the priority, and in this case it can be done economically, Forgie said.

Source: University of Alberta

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