Efficacy of laparotomy sponges to reduce bacterial contamination using an in vitro gastrointestinal surgery model

Abstract

Use of laparotomy sponges to protect abdominal viscera during gastrointestinal surgery is described in nonspecific terms by various sources, but no definitive guidelines have been established in veterinary literature. The objective of this study was to compare the in vitro efficacy of various layer-densities of laparotomy sponges at reducing bacterial contamination from multiple contaminant volumes during multiple exposure times. A standardized Escherichia coli inoculum water solution was applied over sterile laparotomy sponges overlying blood agar plates. Four laparotomy sponge layer-densities, 4 volumes of E. coli inoculum water solution, and 4 exposure times were evaluated. All blood agar plates were incubated for 48 hours followed by surface area measurements of colonization of each blood agar plate at 24 and 48 hours. The procedure was repeated thrice. Bacterial colonization occurred on 100% (192/192) of inoculated blood agar plates. There was a statistically significant decrease in colonized area with increasing layer-density of laparotomy sponges (P<0.0001). Comparison between the layer-density of sponges were statistically significant in resulting infected area (P<0.01), except comparison between 6- and 8-layers (P = 0.9490). Colonized area was not significantly altered by time of exposure. Results suggested that increasing the layer-density of laparotomy sponges has significant effect on reducing strikethrough bacterial colonization in an in vitro model. The results of this study can be used when performing gastrointestinal surgery to help guide laparotomy sponge use to reduce peritoneal bacterial contamination.