Revista do Colégio Brasileiro de Cirurgiões
https://app.periodikos.com.br/journal/rcbc/article/doi/10.1590/0100-6991e-20253852
Revista do Colégio Brasileiro de Cirurgiões
Artigo de Revisão

Bactérias viáveis em instrumental cirúrgico pronto para uso: há esse risco?

Can viable bacteria be present in the surface of ready-to-use surgical instruments?

Carlos Roberto de Oliveira Sauer; Francisco Hideo Aoki; Rogério Hakio Kuboyama; Márcia Regina Suzuki De Lima; Inês Helena de Barros Leal Saraiva; Cely Barreto Silva; Francisco Américo Fernandes Neto; Mauro José Da Costa Salles

http://dx.doi.org/10.1590/0100-6991e-20253852 RCBC, vol.52, e20253852, 2025
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Resumo

Introdução: biofilmes são considerados um desafio no tratamento de doenças crônicas e, após uma observação detalhada dos processos de limpeza e esterilização, podemos considerar que biofilmes podem representar uma ameaça à esterilidade dos instrumentos cirúrgicos prontos para o uso. É frequente o uso de fitas plásticas coloridas para auxiliar na montagem das caixas de instrumental cirúrgico, as quais formam um ressalto que dificulta a limpeza do material. Corroborando isso, temos dados epidemiológicos demonstram altas taxas de infecção de sítio cirúrgico, havendo regiões do Brasil cuja taxa chega a 24%. O objetivo deste estudo é responder a pergunta: é possível existir biofilme em instrumental cirúrgico pronto para uso?

Método: revisão de literatura narrativa.

Resultados: foram encontrados 296 artigos e selecionados, para leitura detalhada, um total de 163 artigos, dos quais foram incluídos 78 artigos. Durante o levantamento delineou-se quatro núcleos: microbiologia, fisiopatologia/epidemiologia, tecnologia e gestão. Artigos destas diferentes áreas de conhecimento indicam que a carga bacteriana prévia à autoclavagem, o comprometimento da eficiência do método de esterilização na presença de sujidades microscópicas e a dificuldade das Centrais de Material e Esterilização em assegurar a limpeza adequada deixam dúvidas sobre a garantia de esterilidade dos materiais cirúrgicos.

Conclusão: há um considerável risco de existir biofilmes bacterianos em instrumental cirúrgico pronto para o uso, o que justifica maiores investimentos nessa área de pesquisa em microbiologia, com ênfase no aperfeiçoamento dos indicadores de qualidade do processo, tendo em vista o potencial impacto na redução das taxas de infecção do sítio cirúrgico.

Palavras-chave

Biofilmes; Infecção da Ferida Cirúrgica; Instrumentos Cirúrgicos; Centro de Material e Esterilização; Controle de Infecções

Abstract

Introduction: biofilm is considered a challenge regarding treatment of chronic diseases and, after a detailed observation of cleaning and sterilization processes, it is considered could be a threat to sterility of surgical instruments that are “ready to use”. Colored plastic bands (color coding tapes for marking surgical instruments) are frequently used to assist in the assembly of surgical instrument boxes. These bands form a lifting, which makes cleaning the material difficult. Epidemiological data regarding the frequency of surgical site infection in Brazil (up to 24% in Center-West Region) may be suggestive of contamination of operative instruments. The objective of this study is to answer the question: is there a risk of biofilm on ready-to-use surgical instruments?

Methods: narrative literature review.

Results: 296 articles were found and a total of 163 were selected for detailed reading, of which 78 were included. During the survey, four knowledge domains were outlined: microbiology, pathophysiology/epidemiology, technology and management. This review pointed out the risk of the bacterial load prior to autoclaving, the efficiency of the sterilization method regarding the presence of microscopic soils and, under current conditions, the ability of the Material and Sterilization Centers to ensure adequate cleaning.

Conclusion: after working extensively to associate all the collected information, there is a considerable probability of bacterial biofilms in ready-to-use surgical instruments and, therefore further research in this field of microbiology is justified, with an emphasis on improving process quality indicators, giving the potential impact on reduction of surgical site infection rates.

Keywords

Biofilms; Surgical Wound Infection; Surgical Instruments; Sterile Processing Department; Infection Control

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