Bacterial Colony Counts During Vaginal Surgery

OBJECTIVE To describe the bacterial types and colony counts present before and during vaginal surgery. METHODS A descriptive study was undertaken of patients undergoing vaginal hysterectomy with or without reconstructive pelvic surgery. Aerobic and anaerobic bacterial cultures were obtained immediately before and throughout the surgical cases at preselected time intervals. Standard antimicrobial prophylaxis was administered in all cases. Mean total colony counts and mean anaerobic colony counts were determined by adding all colonies regardless of bacteria type. 'Contamination' was defined as > or = 5000 colony-forming units/ml. RESULTS A total of 31 patients aged 26 to 82 years (mean age +/- SD, 51 +/- 15) were included. The highest total and anaerobic colony counts were found at the first intraoperative time interval. On the first set of cultures (30 minutes after the surgical scrub), 52% (16/31) of the surgical fields were contaminated, and at 90 minutes, 41% (12/29) were contaminated. A negligible number of subsequent cultures were contaminated. CONCLUSIONS Any future interventions designed to minimize bacterial colony counts should focus on the first 30 to 90 minutes of surgery.