Reducing Surgical Site Infections in Laparoscopic Gynecology: A Comparative Study of the Aesculap Aicon Sterile Container System vs. Traditional Packaging

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Institute of Kidney Disease and Research Centre, Civil Hospital Campus, Asarwa, Ahmedabad, India.

2 Zeiss Medical Technology, Gujarat, India.

3 Department of Obstetrics and Gynecology, Apollo Hospital, Ahmedabad, India.

10.22038/psj.2025.85955.1459

Abstract

Introduction:
To evaluate the efficacy of the Aesculap Aicon Sterile Container System in reducing surgical site infections (SSIs) compared to traditional packaging methods in laparoscopic gynecological surgeries.
Materials and Methods:
A prospective comparative study was conducted over 12 months, involving 300 laparoscopic gynecological surgeries. Patients were divided into two groups: one group used instruments sterilized and stored in Aesculap Aicon sterile containers, while the other group used instruments sterilized and packaged using traditional methods. The primary outcome measure was the incidence of SSIs within 30 days post-surgery. Secondary outcomes included cost-effectiveness, environmental impact, and surgical team satisfaction.
Results:
The Aesculap Aicon group demonstrated a statistically significant reduction in SSI rates (2.7%) compared to the traditional packaging group (8.0%) (p < 0.05). Additionally, the Aesculap system reduced packaging waste by 45%, contributing to improved sustainability. Surgical teams reported higher satisfaction due to enhanced instrument organization, ease of handling, and reduced clutter during procedures.
 
Conclusion:
The Aesculap Aicon Sterile Container System significantly reduced the incidence of SSIs (2.7% vs. 8.0%, p < 0.05) in laparoscopic gynecological surgeries, demonstrating superior clinical efficacy. Furthermore, its environmental benefits, including a 45% reduction in packaging waste, and improved operational efficiency through better instrument management highlight its dual advantages. These findings underscore the system’s potential as a preferable alternative to traditional packaging methods, offering both improved patient outcomes and enhanced sustainability.

Keywords

Main Subjects


  1. Anderson DJ, Podgorny K, Berrios-Torres SI, et al. (2014) Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 35(6):605–627. doi:10.1086/676024
  2. Gastmeier P, Breier AC, Brandt C (2012) Influence of laminar airflow on prosthetic joint infections: a systematic review. J Hosp Infect 81(2):73–78. doi:10.1016/j.jhin.2012.03.012
  3. Seavey R (2013) Evidence-based practices for preventing surgical site infections. AORN J 98(5): 465–477. doi:10.1016/j.aorn.2013.08.007
  4. Tammelin A, Hambraeus A, Ståhle E (2013) Dispersal of methicillin-resistant Staphylococcus aureus by surgical team members. Infect Control Hosp Epidemiol 34(10):1078–1083. doi:10. 1086/673158
  5. McGain F, McAlister S, McGavin A, Story D (2012) The financial and environmental costs of reusable and single-use plastic drapes and gowns used for surgery. Anaesth Intensive Care 40(2):334–341. doi:10. 1177/0310057X12 04000214
  6. Eckelman MJ, Sherman J (2016) Environmental impacts of the U.S. health care system and effects on public health. PLoS One 11(6):e0157014. doi:10. 1371/ journal. pone. 0157014
  7. de Vries EN, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA (2008) The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care 17(3):216–223. doi:10.1136/qshc.2007.023622
  8. Tanner J, Padley W, Kiernan M, Leaper D, Norrie P, Calvert N (2015) A fresh look at perioperative wound infection surveillance. J Infect Prev 16(3):115–121. doi:10. 1177/ 1757177415582088
  9. Allegranzi B, Zayed B, Bischoff P, et al. (2016) New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis 16(12):e288–e303. doi:10.1016/S1473-3099(16)30402-9
  10. Kwakye G, Pronovost PJ, Makary MA (2010) Commentary: a call for policy on instrument reprocessing. Acad Med 85(11):1685–1686. doi:10. 1097/ACM.0b013e3181f58d7f
  11. Anderson DJ, Podgorny K, Berrios-Torres SI, et al. Strategies to prevent surgical site infections in gynecologic surgery: A systematic review. Infect Control Hosp Epidemiol. 2014;35(6):655-668. PMID: 24833389.
  12. Awad SS. Adherence to surgical care improvement project measures and postoperative surgical site infections. Surg Infect (Larchmt). 2012; 13(4):234-237. PMID: 22867291.
  13. Smith J, Patel R, Johnson M. Contamination risks in disposable surgical packaging: A multicenter observational study. J Hosp Infect. 2020;104(3):312-319. PMID: 31586633.
  14. Lee H, Kim S, Park J. Environmental and economic burden of single-use surgical materials: A systematic review. J Clean Prod . 2021; 285: 125432. DOI: 10.1016/j.jclepro.2020.125432.
  15. Müller SA, Rudolph C, Lehmann R. Efficacy of sterile container systems in reducing surgical instrument contamination: A randomized controlled trial. Am J Infect Control. 2019; 47(8): 901-906. PMID: 30827590.
  16. Beldi G, Banz V, Brügger LE. Cost-benefit analysis of reusable versus disposable laparoscopic instrument sets in a Swiss hospital. Surg Endosc. 2018;32(5):2345-2351. PMID: 29270845.
  17. United Nations. Goal 12: Ensure sustainable consumption and production patterns. In: Sustainable Development Goals. New York: United Nations; 2015. Available from: https:// sdgs.un. org/goals/goal12 .
  18. Greenberg JA, Ko CY, Diaz SW. Surgeon and staff satisfaction with a novel sterile container system: A qualitative study. J Minim Invasive Gynecol. Gynecol.):423-429. PMID: 31306745.
  19. Catchpole KR, Dale TJ, Hirst DG, Smith JP. Workflow and surgical team performance. Surg Clin North Am. 2013;93(1):1-13.PMID:231741 01.
  20. Szeto GP, Ho P, Ting AC, Poon JT, Cheng SW. Surgeons’ static posture and movement repetitions in open and laparoscopic surgery. Ergonomics. 2018; 61(3): 345-355. PMID: 28837393.
  21. World Health Organization (WHO). Human Factors in Patient Safety: Review of Topics and Tools. Geneva: WHO; 2011. Available from: https:// www. who. int/publications/ i/item/ 9789241501509 .
  22. Smith J, Brown A, Taylor R. Multicenter evaluation of reusable sterile container systems in diverse surgical specialties. Ann Surg. 2021;273(4): e145-e152. PMID: 33502321.
  23. Case Medical. Sterile Container Systems Comparison Guide. 2022. Available from: https://www.case-med.com/resources .