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Hi Michael,
No worries.
We use disposable markers, one use only as about 40% of our clients are colonised with nmMRSA long before they get near a hospital.
I have seen, however, the only healthy kidney removed and the wrong limbs operated on and removed so just want to remind us all of the bigger picture.
I have also had the reason for not marking the limb as the lack of the ‘correct’ pen.
May well be a local issue but always worth keeping it in mind when educating staff!
The articles are certainly interesting. Sometimes you are damned if you do and damned if you don’t.
Always an interesting and informative site.
Kind regards,
Lynley
Sent from mikala, the iPad!
On 05/06/2013, at 19:26, Michael Wishart wrote:
> Hi Lynley
>
> If this was only about amputation of infected limbs and digits which were then discarded, it would be less concerning. But safe surgery protocols now require us to mark every site and side for every surgical procedure that has laterality (except mucous membrane areas, basically). So your professional athletes having joint surgery, your women having breast surgery, the diabetic patient having foot amputation for chronic infection: they all need the correct site marked. We obviously want to do everything we can to reduce risks of infection in all of our patients.
>
> That is what the question is aimed at: what is the risk, and what should we do to minimise such risk?
>
> Apologies if this sounds dictatorial, but I feel we need to focus on why we are discussing this.
>
> Cheers
> Michael
>
> Michael Wishart
> CNC Infection Control
> Holy Spirit Northside Private Hospital
> 627 Rode Road, Chermside, Qld 4032
> t: (07) 3326 3068 | f: (07) 3326 3523
> e: Michael.Wishart@hsn.org.au
> w:www.holyspiritnorthside.org.au
> Please consider the environment before printing this email
>
> ________________________________________
> From: ACIPC Infexion Connexion [AICALIST@AICALIST.ORG.AU] on behalf of Lynley King [lynleyk@TPG.COM.AU]
> Sent: Wednesday, 5 June 2013 7:15 PM
> To: AICALIST@AICALIST.ORG.AU
> Subject: Re: Pens for marking skin prior to surgery
>
> Hi All,
>
> I would still prefer to mark the leg then have the wrong one amputated.
> Happens more often then you might think!
>
> Just a thought.
>
> And if the leg is being amputated what is the risk of infection following surgery?
> And as the leg is being amputated (usually due ti infection) isn’t the site left at increased risk anyway?
>
> Just curious.
>
> Lynley
>
> ICP
> Alice Springs Hospital
> CAHN
>
>
>
>
> Sent from mikala, the iPad!
>
> On 05/06/2013, at 11:56, Michael Wishart wrote:
>
>> Hi Irene
>>
>> Good question, some aspects of which has already been discussed in the literature, but with conflicting opinions.
>>
>> http://www.medpagetoday.com/MeetingCoverage/ICAAC-IDSA/11440
>>
>> http://patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2008/Dec5(4)/Pages/130.aspx
>>
>> Some of those referred studies seem to indicate different brands will act differently. The most interest finding I saw was that in one study, MRSA remained on all types of felt tips tested.
>>
>> So, the question remains: is it possible to transfer microorganisms via felt tip pens? Without doing a full study on whichever brand of felt tip pen we chose, I would be reluctant to say a definite yes for all different marking pens.
>>
>> Should we rely solely on antiseptic skin prep prior to the procedure? I think would much depend on where the site was marked… I have seen limbs marked prior to surgery well below where the area was be prepped with antiseptic.
>>
>> At the very least, the body of the marking pens should be wiped over between uses to avoid transfer of MRO’s onto the hands of whoever handles it, as these pens have direct contact with patients. Carrying a marking pen for the purpose of limb marking in one’s pocket ‘until it runs dry’ seems to be asking for problems (and not just from staining of the pockets from ink!).
>>
>> More discussion on this would be appreciated. I recognise that sterile marking pens have been used within the sterile field for a long time, but should we use these same disposable sterile markers for pre-operative limb marking as required for safe-site surgery protocols?
>>
>> Cheers
>> Michael
>>
>> Michael Wishart
>> CNC Infection Control
>> Holy Spirit Northside Private Hospital
>> 627 Rode Road, Chermside, Qld 4032
>> t: (07) 3326 3068 | f: (07) 3607 2226
>> e: Michael.Wishart@hsn.org.au
>> w:www.holyspiritnorthside.org.au
>> Please consider the environment before printing this email
>>
>>
>>
>> —–Original Message—–
>> From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Wilkinson, Irene (Health)
>> Sent: Wednesday, 5 June 2013 12:03 PM
>> To: AICALIST@AICALIST.ORG.AU
>> Subject: Re: Pens for marking skin prior to surgery
>>
>> Hi all,
>>
>> Is there any evidence that texta markers are a vehicle for transmission of microorganisms?
>> Th
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