Background: Over the past decade, wrong-site surgery has been a
popular topic of discussion, not only in medical and legal journals but also
in the mainstream press. Marking of the surgical site according to the Joint
Commission on Accreditation of Healthcare Organizations (JCAHO) Universal
Protocol was implemented at our institution to help reduce the number of
wrong-site operations. In this study, we determined whether marking of the
site affected the sterility of the surgical field.
Methods: The study included twenty volunteers. The right forearm was
used as the experimental (marked) arm and the left forearm, as the control
arm. The experimental forearms were marked with a surgical marker as described
by the protocol. Both upper extremities were then sterilized from the
antecubital fossa to the phalanges with a 7.5% povidone-iodine scrub followed
by the application of a 10% povidone-iodine paint. Swabs were used to obtain
samples from the experimental and control arms as well as from the marker and
were sent for microbiological culture and analysis.
Results: No growth was seen in the cultures of the swabs used on the
experimental or control arms or on the marking pens.
Conclusions: Preoperative marking of surgical sites in accordance
with the JCAHO Universal Protocol did not affect the sterility of the surgical
field, a finding that provides support for the safety of surgical site