September 2, 2025 • 23 mins
Thermal glass bead disinfection could revolutionize how veterinary clinics manage instrument hygiene between patients. On this episode of Veterinary Vertex, we dive deep with researchers Steven Frederick and Dr. KP Spivey into their groundbreaking study showing how this technology effectively eliminates bacteria from suture scissors in just 60 seconds.
The conversation reveals surprising findings about bacterial contamination in veterinary settings. Roughly a third of pre-disinfection samples showed clinically relevant bacterial growth, including multi-drug resistant organisms—a stark reminder of cross-contamination risks in busy practices. After 60 seconds of glass bead disinfection, researchers found zero detectable bacterial growth on any scissors tested, demonstrating remarkable effectiveness against a wide range of pathogens.
Beyond the clinical implications, this research highlights significant operational benefits. As Steven explains, traditional sterilization protocols demand substantial technician time, require extensive instrument inventories, and generate considerable environmental waste through disposable packaging. Glass bead disinfection offers a practical middle ground that maintains patient safety while addressing real-world constraints of busy clinical environments. The researchers also discuss the potential for expanding this approach to other instruments and explore emerging technologies like ultraviolet wave disinfection that could further transform infection control practices.
Perhaps most valuable is the researchers' perspective on innovation in veterinary medicine. They emphasize that sometimes the most transformative ideas come from unexpected sources—students, new technicians, or even clients who bring fresh perspectives. Their work exemplifies how questioning established protocols can lead to practical solutions that enhance patient care while improving efficiency and sustainability. Tune in to discover how this simple technology could change your practice's approach to infection control!
Don't forget to subscribe to Veterinary Vertex and leave us a review wherever you get your podcasts.
Open access AJVR article: https://doi.org/10.2460/ajvr.25.04.0123
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
From the makers of vet-recommended Greenies Dental
Treats comes an easy way tosupport your dog's wellness.
Greenies Smart Essentials dryfood delivers complete, balanced
nutrition with science-backedrecipes.
Greenies Supplements, developedby a team of PhD animal
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(00:22):
digestion and more, Whether it'smealtime or mobility support.
Greenies helps you care foryour dog from the inside out.
Learn more at Greeniescom.
Speaker 2 (00:35):
You're listening to Veterinary Vertex, a podcast of
the AVMA Journals.
In this episode, we chat abouthow a thermal glass bead device
provides an effective method ofrapid disinfection of suture
scissor blades in a veterinaryenvironment, with our guests
Stephen Frederick and KP Spidey.
Speaker 3 (00:54):
Welcome listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have Stephen and KPjoining us.
Thank you guys so much, duringthis crazy time of fall and new
students and returning residents, to take your time out to be
with us here today.
We appreciate it.
Speaker 4 (01:12):
Yeah, thank you for having us.
Speaker 2 (01:13):
All right, let's dive right in.
So, kp, your AJBR articlediscusses how glass bead
disinfection may be a moreefficient and cost-effective
alternative to truesterilization for lowering the
risks of cross-contaminationassociated with the use of
suture scissors in a veterinarysetting.
Please share with our listenersthe background on this article.
Speaker 5 (01:34):
Yeah.
So whenever we close anincision, commonly if it's
something that's a largeincision or there's a lot of
tension, we'll often place trueskin sutures versus an
intradermal closure that weremove once that incision's
healed.
To that we use suture scissors.
The challenge of that is, whenused, these suture scissors are
(01:58):
in direct contact with both thatsuture material but commonly
the patient's skin.
If you're like my dog, you'vealready regrown your fur next to
that incision and so there's apotential for bacterial
contamination.
And in an ideal world everypair of scissors would be
sterilized between patients.
But in a busy clinicalenvironment that often just
(02:19):
isn't very practical.
Sterilization requires time.
You know equipment of theautoclave and you have to have
an instrument inventory torotate through to have one
available for every patient.
So as a result, in manypractices I think we use suture
scissors with varying degrees ofcleaning and disinfection
between them, and I think, justas a matter of convenience.
(02:39):
But unfortunately this doescreate a risk for
cross-contamination, especiallywith considering, unfortunately
nowadays, how commonmultidrug-resistant bacteria are
in veterinary hospital settings.
So class B disinfection hashistorically been used in other
fields like dentistry andparticularly in lab animal
(02:59):
medicine as a quick way todisinfect instrument tips
medicine as a quick way todisinfect instrument tips.
It's important to know thatit's not the same as full
sterilization, but it cansubstantially reduce bacterial
load in a fraction of the time.
So we wanted to take a look atthis specifically towards the
application of suture removalscissors in veterinary medicine,
(03:21):
particularly for healedsurgical sites where we
anticipated our bacterial loadto be pretty low.
Speaker 2 (03:27):
Yeah, what a cool study, and people, too, on
social media are definitelytalking about it as well.
We did a promotional post andit was cool to see the
conversation of people beinglike wow, that would really help
in my clinic.
We're so busy.
This would be great ways for usto implement this.
So thank you for sharing that,too, with our readers.
Speaker 5 (03:49):
Yeah for sure I know, being a surgical resident, we
could have anywhere from youknow, eight to 12 suture removal
appointments in a day.
So definitely something thathaving a quicker option is
definitely there's a need, ohfor sure and KP.
Speaker 2 (03:58):
what are the important take-home messages
from this article?
Speaker 5 (04:00):
Yeah, I think the most important takeaway is that
it worked, and not only that itworked, that it worked
consistently.
I think that was kind ofsomething that I think is the
main takeaway of this study,because in the pre-disinfection
samples about a third hadclinically relevant bacterial
growth, including some kind ofreally nasty multi-drug
(04:24):
resistant organisms, and just 60seconds with that glass bead
disinfection, none of thescissors had detectable growth
on the post-disinfection samples.
So again, that sterilization isalways going to be the gold
standard.
This isn't going to replacethat.
You know you still have got toput your full instrument packs
through scrub and autoplay ofsterilization.
(04:47):
But for something where yourbacterial load is expected to be
relatively low, like in healedincisions, this could be a
really useful application.
And I think ultimately, thebottom line takeaway is that
this is about seeingpracticality with patient safety
, and I think it's somethingthat's a pretty low investment
(05:08):
in terms of cost, time, training.
Anyone can do this to overallimprove patient care Very cool,
stephen, over to you.
Speaker 3 (05:18):
What sparked your interest in studying this?
Were you at the dentist and sawhow they were doing it quickly?
Or just thinking that's nasty,that we're using the same suture
scissors and just wiping themwith alcohol or what?
What?
What sparked your like, hey, weshould look at this.
How do you even find out aboutthe glass bead sterilization
method?
Speaker 4 (05:35):
yeah, so I.
I've been a credentialedtechnician with a specialty in
surgery for over 15 years, andso in surgical site infections
are a pretty consistent part ofmy life.
Unfortunately, in our practicewe actually in our ophthalmology
suite where they're doing somethings like eyelid mass removals
(05:58):
that are not necessarilyinvasive and are fairly low risk
for infection and contamination.
They actually had this devicein there, and that's where I
first found out about it, andover the years I just kept
thinking there's got to besomething that we can be doing
with this machine to help therest of the surgery department.
(06:19):
It's not just for eyelid massremovals.
I knew that they use them indentistry.
Ooh, this would be a reallygreat way for us to disinfect
our suture scissors, our bandagescissors, things like that.
Obviously, we didn't testbandage scissors in this case,
(06:40):
but it was next on my list.
Suture scissors just seemedmore feasible and applicable.
But really just the goal oflimiting contamination while
also bringing up efficiency.
We as technicians are asked todo a lot of things, including
the cleaning and sterilizing ofthose instruments, and knowing
(07:04):
that I could be contributingmore to patient care if I didn't
have to spend all that timesterilizing 15 pairs of scissors
a day was really a big sellerfor me, as well as just the
environmental impact of all ofour surgical waste in a daily
basis.
If we're not having to open andthrow away sometimes
(07:27):
double-packed peel pouches,that's a lot of waste per year
that we can avoid, and so therewere quite a number of reasons
that this kind of rang true tome.
Speaker 3 (07:39):
That's a fantastic point, stephen.
You know that would be actuallya really great article to do to
say this is the people cost andthe environmental cost to
sterilization.
And then, as you said, you needto own 15 pair like 15 mini
packs, right, you have to have15 mini packs of Brown-Adson or
whatever.
You use rat tooth and thesuture removal scissor.
And that's people, right?
(08:00):
People, as you know, are themost expensive time and we don't
want our veterinarians or ourtechnicians doing things like
packing when they could be doingenhancing patient care.
So that would be a really, youknow, an environmental survey of
what you're saving there aswell.
Very, very cool.
While I have you, stephen, as Ijust I mean, you need suture,
(08:22):
you need some type of forcep too, a brown adson or a rat tooth
or something.
Did you look at that too, or isthat coming for us next?
Speaker 4 (08:31):
We did not.
We chose to focus just on thesuture blades because this was a
resident project.
We wanted to make it veryachievable, very directly
relatable, so we focused on asingle instrument instead of
bringing in other potentialholdups or confounders.
I think that it's a reallygreat point that a suture
(08:53):
removal is not a singleinstrument procedure and we do
need to extrapolate this intoother stainless steel heatable
instruments that we could dothis with.
I mean, just bandage scissorsare a big one for me, because
we've all seen a really nastywound bandage that's used.
(09:15):
Somebody wipes it down withalcohol gauze and then puts the
scissors in their pocket again.
Even something like a stylet ora specula could be other
(09:40):
alternative studies that weshould be looking at, because
there's a lot of instrumentsthat we use in daily practice,
whether in surgery or medicineor emergency, that could really
benefit from these types ofdisinfection protocols where
we're just not being efficientor we're putting the active
(10:02):
patient care over the kind ofpassive patient care.
Speaker 3 (10:06):
Well said, KP.
Earlier Sarah asked you whatwere the important take-home
messages.
But every time we do any sortof study, there's things that
surprise us, and then, of course, it leads to more studies,
which we hope come our way.
What were some of thesurprising findings for you and
Stephen in this article?
Speaker 5 (10:23):
Yeah, I think kind of two things.
One, reiterating on that mainhighlight is just the
effectiveness of this instrument, especially against the wide
range of bacteria that we'reseeing.
And I think that was anotheraspect that I found interesting
is, you know, even though it wasabout a third, still a pretty
significant portion, I would say, of healed incisions.
(10:47):
You know, carry that bacteriaflora around that incision and I
think it may help explainanecdotally sometimes why we see
a patient.
You know, at that 10 to 14 daymark that that incision is
healed, we give the owner theokay to start to bathe, back in
normal activity, remove thatcone and then start to have
complications and problems withthe incision.
(11:09):
I think sometimes we forget that.
You know we try to create asaseptic of an environment at the
time of surgery, but that'stemporary.
You know there's bacteria,whether it's going to be skin
flora that colonize that area,which definitely, you know our
staff species were most common.
But other things you know had avariety of bacteria that played
(11:30):
a role here.
Bacteria that played a rolehere and I think also kind of
extrapolating it a little bit,goes to show the importance of
glove wearing, hand washingbetween handling patients for
any reasons you just don't knowkind of what bacteria are going
to be present, and making surethat we don't spread that
between patients, because whatmay not cause a problem for one
(11:52):
patient could potentiallypresent a problem to another
patient.
Speaker 2 (11:55):
Yeah, I feel like hand washing is a big theme of
our podcast episodes lately.
We used to do one on salmonellaand they were like talking
about how long salmonella canlive on like picnic tables.
It was horrifying to learn that.
So please wash your hands ifyou're listening to this.
It applies in a variety ofsettings.
So, Stephen, what are the nextsteps to research into the
science of care delivery as itrelates to minimizing nosocomial
(12:19):
surgical site infections?
Speaker 4 (12:21):
Sure.
So I'm not sure the termscience of care delivery is
widely used, but it's what weuse in our science department at
Blue Pearl.
So basically what we're lookingat is how can we take
evidence-based solutions andfind evidence-based solutions
for different care items that wetypically do in the hospital
(12:46):
setting, and so for minimizingnosocomial infections.
Obviously, as I alluded tobefore, there's other studies to
be done with the glass beaddisinfection device, but there's
also new technology on themarket that may be out of reach
financially for most practicesright now, but hopefully as the
technology improves there's moremarket competition, they'll be
(13:09):
more accessible to us.
The one that I think ofprimarily is the use of
ultraviolet wave technology fordisinfection.
So there are actually entireroom devices that will use
technology and a camera tovisualize all the surfaces, know
exactly the contours of theroom and it will use ultraviolet
(13:33):
technology to disinfect allsurfaces.
Right now we've got technicians,assistants, anybody scrubbing
the walls of isolation wards,the operating rooms, between
procedures, especially implantprocedures like total joint
replacements.
That's a lot of time, that's alot of money, it's a lot of
(13:54):
potential toxic exposure tofumes from those cleaning agents
and we're probably still doinga less effective job than this
single device could do, and sothose are kind of the next steps
, I think, in researching how wecan better prevent infection.
(14:14):
Obviously there are some whereit's just the transfer from the
clinical staff to the animal,and so there are options there
as well.
But if we're really looking atjust how can we better disinfect
and make sure that the bioburden around the hospital is
lower, I think that ultravioletlight is a really cool aspect
(14:35):
that we could focus on.
Speaker 2 (14:36):
Yeah, I really like the theme too of just like
enhancing the time that we havewith our technicians and really
just using our credentialtechnicians to the most that we
can.
So that's another great tool, Ithink, in that respect as well.
Speaker 3 (14:47):
Hey, kp, this was your resident project.
It's not easy to ever come upwith a really cool idea while
you're a busy resident.
Design it, get it done, get itwritten, get it published.
So well done you.
How did all of that trainingprepare you to write this
article?
Speaker 5 (15:04):
Yeah, so back in college I actually was a
microbiology teaching assistantfor several semesters, so
fortunately you have a littlebit of familiarity with things
like bacterial culture, plating,dilutions, things like that.
So that definitely came in handyfor the materials and methods
technical part of the study.
But definitely, you know, Ithink that is a challenge of any
(15:27):
residency requirement that doeshave a publication, because
that's not what I'm doingresearch on a daily basis.
So in regards to all the otheraspects of the research side, I
believe it was my first year ofresidency Blue Pearl actually
started a resident researchforum, kind of a weekend
conference, kind of the nittygritty about everything you need
(15:48):
to know, from developing ideato getting the manuscript
published to tips at presentingat conferences, and it's been a
really good resource for thosethat you know just don't have a
lot of previous clinicalresearch experience, myself
included, and I definitely couldhave not done this without my
residency program advisor, drZyla, who's also on the study,
(16:12):
and Stephen as well, especiallya lot of support when it came to
revising the manuscript andgoing through the review process
.
Speaker 2 (16:19):
So, stephen, this next set of questions is going
to be very important for ourlisteners, and the first one is
going to deal with theveterinary team.
So, stephen, what is one pieceof information the veterinary
team should know about thescience of care delivery?
Speaker 4 (16:45):
the best practice or the most efficient way to still
give great care, becauseultimately, that's our goal is
to give optimal care to ourpatients.
But I think that one thing thatwe may overlook is that this is
one time where the student orthe new assistant or technician
fresh out of school may reallybe the best contributor.
We that have been in practicefor many years have a lot of
(17:07):
training, have a lot ofexperience, tend not to think
outside the box as much.
I mean, we adopt new thingsthat are evidence-based, that
are in the literature, but wedon't necessarily think in
day-to-day oh I wonder if Itried this.
Whereas people that don't haveall of that baggage, as it were,
may be more likely to askquestions, though I worry that
(17:31):
they feel dumb about it.
So I really want to encouragethe whole team to realize that
there's no dumb question here.
By asking these questions, weget to find better ways to do
things and ultimately keepproviding great care, but maybe
make things so that they aremore approachable, more
affordable for clients, becauseright now we know that we're
(17:54):
currently we're we're quicklybecoming outpriced for for the
market and that's a realhardship on our, our clients,
and ultimately we want to beable to treat as many patients
as we can.
So keep asking those questions.
Nothing is dumb.
Throw it out there and look forthe evidence behind what you're
looking for.
Speaker 3 (18:14):
Stephen.
I love that.
I would say that in my 30 plusyears as a clinician scientist,
my best questions, meaning themost impactful for human and
veterinary medicine came frompeople that are like I have a
really dumb question.
It could have been a student, atechnician, a resident,
somebody in the sidelines aftera talk I have a really dumb
(18:34):
question.
And I was like, huh, actuallywe don't know if that's true,
that's a great question.
Speaker 2 (18:39):
So I concur, and Stephen on the other side of the
relationship.
What's one thing that clientsshould know about this topic?
Speaker 4 (18:47):
I would like our clients to know that we're doing
the best we can.
We are doing what the evidencetells us to do, because a lot of
these topics we don't have newor current or kind of best fit
evidence for every situation.
Things are changing so quicklyand the more that we can do
(19:10):
frankly, kind of simple studieslike this, the better we'll be
able to help them.
But in the meantime I just askfor their patience.
We are doing it.
I mean the same that I saidwith the students kind of new
techs, new assistants.
If a client has experience fromanother background that may
(19:31):
contribute, have them bring itup to you.
Feel free to talk to yourveterinarian about, or their
team about, how we mightapproach something differently
to make it more approachable forthe client side of things,
because we get wrapped up in themedicine and we don't always
look at it from that side.
So just have an open dialogue.
Speaker 3 (19:53):
Very funny, stephen.
Give us their patience.
Yeah Well, I have you.
As we wrap up, we like to ask alittle more of a light-sided
question.
Stephen, if you have it, youcan show us what is the oldest
or most interesting item on yourdesk or in your desk drawer.
Speaker 4 (20:10):
So not technically on my desk, it's on the bookshelf
behind me.
I've got this great picture ofa rabbit and it's actually made
by a former technician that Iworked with, who had been an
artist before coming to theveterinary field as so many of
us have multiple careers and hername is Cheryl Polcaro.
(20:31):
During her training, they werepracticing imaging, took an
x-ray of the neck and head of arabbit and then she used mixed
media to draw the shape of arabbit and the soft tissue
around the skull, and so it'sreally coming from an
orthopedics background.
I love it because I get to seethe skeleton but also appreciate
(20:53):
that it's a rabbit and see thekind of the inner workings, and
I think it's a really cool wayto use that image and not waste
that piece of kind of medicalhistory that we have there.
Speaker 3 (21:08):
Very cool.
And did you know, stephen, thatJabma Cover Art?
We prioritize art from theveterinary team, so
veterinarians, veterinarytechnicians, so we don't solicit
.
Well, I mean, lots ofveterinary technicians and
veterinarians have professionalart, but we prioritize it from
our own veterinary family.
Speaker 4 (21:28):
Okay, I will definitely put the word out to
her on that.
I think she would be honored tohave some of her art on the
cover there.
Speaker 3 (21:35):
Yeah, excellent KP for you.
What's your favorite animalfact?
Speaker 5 (21:39):
Yeah, so you're going to get a bonus because a
pertinent fact about me leadsinto my animal fact that it's
kind of polarizing.
But banana is my favorite, likecandy flavor, like banana Laffy
Taffy banana runts, which Iknow a lot of people hate banana
.
But I recently found out thechemical compound that is used
to create artificial bananaflavor is chemically identical
(22:03):
to one of the alarm pheromonesfor honeybees.
So caution to use educatedjudgment of where you enjoy your
banana flavored candy.
Don't make the bees angry.
Speaker 3 (22:16):
That's an awesome fact.
I love it and I'm definitelyallergic to ground bees, so I
will keep that in mind, becauseI love that nasty fake banana
flavor too.
Speaker 2 (22:26):
It's a good time of year, too, to share that fact.
I feel like this is the time ofyear where you see more bees
they're like coming out.
I was at a picnic and it wasjust the food was swarmed with
them.
I didn't eat any of the foodthere we eat.
Afterwards I was like I'm nottouching that.
Thank you, kp, for being herewith us this morning and also
for sharing your manuscript, too, with our AJVR readers.
Speaker 5 (22:45):
Thanks so much for inviting us.
We appreciate it.
Speaker 4 (22:47):
Yes, it was a great time.
Speaker 2 (22:54):
And to our listeners.
You can read Stephen and KP'sarticle on AJVR.
I'm Sarah Wright with LisaFortier.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
From the makers of vet-recommended Greenies Dental
Treats comes an easy way tosupport your dog's wellness.
Greenies Smart Essentials dryfood delivers complete, balanced
nutrition with science-backedrecipes.
Greenies Supplements, developedby a team of PhD animal
nutritionists, offers options tohelp support healthy joints,
(00:22):
digestion and more, Whether it'smealtime or mobility support.
Greenies helps you care foryour dog from the inside out.
Learn more at Greeniescom.
Speaker 2 (00:35):
You're listening to Veterinary Vertex, a podcast of
the AVMA Journals.
In this episode, we chat abouthow a thermal glass bead device
provides an effective method ofrapid disinfection of suture
scissor blades in a veterinaryenvironment, with our guests
Stephen Frederick and KP Spidey.
Speaker 3 (00:54):
Welcome listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today we have Stephen and KPjoining us.
Thank you guys so much, duringthis crazy time of fall and new
students and returning residents, to take your time out to be
with us here today.
We appreciate it.
Speaker 4 (01:12):
Yeah, thank you for having us.
Speaker 2 (01:13):
All right, let's dive right in.
So, kp, your AJBR articlediscusses how glass bead
disinfection may be a moreefficient and cost-effective
alternative to truesterilization for lowering the
risks of cross-contaminationassociated with the use of
suture scissors in a veterinarysetting.
Please share with our listenersthe background on this article.
Speaker 5 (01:34):
Yeah.
So whenever we close anincision, commonly if it's
something that's a largeincision or there's a lot of
tension, we'll often place trueskin sutures versus an
intradermal closure that weremove once that incision's
healed.
To that we use suture scissors.
The challenge of that is, whenused, these suture scissors are
(01:58):
in direct contact with both thatsuture material but commonly
the patient's skin.
If you're like my dog, you'vealready regrown your fur next to
that incision and so there's apotential for bacterial
contamination.
And in an ideal world everypair of scissors would be
sterilized between patients.
But in a busy clinicalenvironment that often just
(02:19):
isn't very practical.
Sterilization requires time.
You know equipment of theautoclave and you have to have
an instrument inventory torotate through to have one
available for every patient.
So as a result, in manypractices I think we use suture
scissors with varying degrees ofcleaning and disinfection
between them, and I think, justas a matter of convenience.
(02:39):
But unfortunately this doescreate a risk for
cross-contamination, especiallywith considering, unfortunately
nowadays, how commonmultidrug-resistant bacteria are
in veterinary hospital settings.
So class B disinfection hashistorically been used in other
fields like dentistry andparticularly in lab animal
(02:59):
medicine as a quick way todisinfect instrument tips
medicine as a quick way todisinfect instrument tips.
It's important to know thatit's not the same as full
sterilization, but it cansubstantially reduce bacterial
load in a fraction of the time.
So we wanted to take a look atthis specifically towards the
application of suture removalscissors in veterinary medicine,
(03:21):
particularly for healedsurgical sites where we
anticipated our bacterial loadto be pretty low.
Speaker 2 (03:27):
Yeah, what a cool study, and people, too, on
social media are definitelytalking about it as well.
We did a promotional post andit was cool to see the
conversation of people beinglike wow, that would really help
in my clinic.
We're so busy.
This would be great ways for usto implement this.
So thank you for sharing that,too, with our readers.
Speaker 5 (03:49):
Yeah for sure I know, being a surgical resident, we
could have anywhere from youknow, eight to 12 suture removal
appointments in a day.
So definitely something thathaving a quicker option is
definitely there's a need, ohfor sure and KP.
Speaker 2 (03:58):
what are the important take-home messages
from this article?
Speaker 5 (04:00):
Yeah, I think the most important takeaway is that
it worked, and not only that itworked, that it worked
consistently.
I think that was kind ofsomething that I think is the
main takeaway of this study,because in the pre-disinfection
samples about a third hadclinically relevant bacterial
growth, including some kind ofreally nasty multi-drug
(04:24):
resistant organisms, and just 60seconds with that glass bead
disinfection, none of thescissors had detectable growth
on the post-disinfection samples.
So again, that sterilization isalways going to be the gold
standard.
This isn't going to replacethat.
You know you still have got toput your full instrument packs
through scrub and autoplay ofsterilization.
(04:47):
But for something where yourbacterial load is expected to be
relatively low, like in healedincisions, this could be a
really useful application.
And I think ultimately, thebottom line takeaway is that
this is about seeingpracticality with patient safety
, and I think it's somethingthat's a pretty low investment
(05:08):
in terms of cost, time, training.
Anyone can do this to overallimprove patient care Very cool,
stephen, over to you.
Speaker 3 (05:18):
What sparked your interest in studying this?
Were you at the dentist and sawhow they were doing it quickly?
Or just thinking that's nasty,that we're using the same suture
scissors and just wiping themwith alcohol or what?
What?
What sparked your like, hey, weshould look at this.
How do you even find out aboutthe glass bead sterilization
method?
Speaker 4 (05:35):
yeah, so I.
I've been a credentialedtechnician with a specialty in
surgery for over 15 years, andso in surgical site infections
are a pretty consistent part ofmy life.
Unfortunately, in our practicewe actually in our ophthalmology
suite where they're doing somethings like eyelid mass removals
(05:58):
that are not necessarilyinvasive and are fairly low risk
for infection and contamination.
They actually had this devicein there, and that's where I
first found out about it, andover the years I just kept
thinking there's got to besomething that we can be doing
with this machine to help therest of the surgery department.
(06:19):
It's not just for eyelid massremovals.
I knew that they use them indentistry.
Ooh, this would be a reallygreat way for us to disinfect
our suture scissors, our bandagescissors, things like that.
Obviously, we didn't testbandage scissors in this case,
(06:40):
but it was next on my list.
Suture scissors just seemedmore feasible and applicable.
But really just the goal oflimiting contamination while
also bringing up efficiency.
We as technicians are asked todo a lot of things, including
the cleaning and sterilizing ofthose instruments, and knowing
(07:04):
that I could be contributingmore to patient care if I didn't
have to spend all that timesterilizing 15 pairs of scissors
a day was really a big sellerfor me, as well as just the
environmental impact of all ofour surgical waste in a daily
basis.
If we're not having to open andthrow away sometimes
(07:27):
double-packed peel pouches,that's a lot of waste per year
that we can avoid, and so therewere quite a number of reasons
that this kind of rang true tome.
Speaker 3 (07:39):
That's a fantastic point, stephen.
You know that would be actuallya really great article to do to
say this is the people cost andthe environmental cost to
sterilization.
And then, as you said, you needto own 15 pair like 15 mini
packs, right, you have to have15 mini packs of Brown-Adson or
whatever.
You use rat tooth and thesuture removal scissor.
And that's people, right?
(08:00):
People, as you know, are themost expensive time and we don't
want our veterinarians or ourtechnicians doing things like
packing when they could be doingenhancing patient care.
So that would be a really, youknow, an environmental survey of
what you're saving there aswell.
Very, very cool.
While I have you, stephen, as Ijust I mean, you need suture,
(08:22):
you need some type of forcep too, a brown adson or a rat tooth
or something.
Did you look at that too, or isthat coming for us next?
Speaker 4 (08:31):
We did not.
We chose to focus just on thesuture blades because this was a
resident project.
We wanted to make it veryachievable, very directly
relatable, so we focused on asingle instrument instead of
bringing in other potentialholdups or confounders.
I think that it's a reallygreat point that a suture
(08:53):
removal is not a singleinstrument procedure and we do
need to extrapolate this intoother stainless steel heatable
instruments that we could dothis with.
I mean, just bandage scissorsare a big one for me, because
we've all seen a really nastywound bandage that's used.
(09:15):
Somebody wipes it down withalcohol gauze and then puts the
scissors in their pocket again.
Even something like a stylet ora specula could be other
(09:40):
alternative studies that weshould be looking at, because
there's a lot of instrumentsthat we use in daily practice,
whether in surgery or medicineor emergency, that could really
benefit from these types ofdisinfection protocols where
we're just not being efficientor we're putting the active
(10:02):
patient care over the kind ofpassive patient care.
Speaker 3 (10:06):
Well said, KP.
Earlier Sarah asked you whatwere the important take-home
messages.
But every time we do any sortof study, there's things that
surprise us, and then, of course, it leads to more studies,
which we hope come our way.
What were some of thesurprising findings for you and
Stephen in this article?
Speaker 5 (10:23):
Yeah, I think kind of two things.
One, reiterating on that mainhighlight is just the
effectiveness of this instrument, especially against the wide
range of bacteria that we'reseeing.
And I think that was anotheraspect that I found interesting
is, you know, even though it wasabout a third, still a pretty
significant portion, I would say, of healed incisions.
(10:47):
You know, carry that bacteriaflora around that incision and I
think it may help explainanecdotally sometimes why we see
a patient.
You know, at that 10 to 14 daymark that that incision is
healed, we give the owner theokay to start to bathe, back in
normal activity, remove thatcone and then start to have
complications and problems withthe incision.
(11:09):
I think sometimes we forget that.
You know we try to create asaseptic of an environment at the
time of surgery, but that'stemporary.
You know there's bacteria,whether it's going to be skin
flora that colonize that area,which definitely, you know our
staff species were most common.
But other things you know had avariety of bacteria that played
(11:30):
a role here.
Bacteria that played a rolehere and I think also kind of
extrapolating it a little bit,goes to show the importance of
glove wearing, hand washingbetween handling patients for
any reasons you just don't knowkind of what bacteria are going
to be present, and making surethat we don't spread that
between patients, because whatmay not cause a problem for one
(11:52):
patient could potentiallypresent a problem to another
patient.
Speaker 2 (11:55):
Yeah, I feel like hand washing is a big theme of
our podcast episodes lately.
We used to do one on salmonellaand they were like talking
about how long salmonella canlive on like picnic tables.
It was horrifying to learn that.
So please wash your hands ifyou're listening to this.
It applies in a variety ofsettings.
So, Stephen, what are the nextsteps to research into the
science of care delivery as itrelates to minimizing nosocomial
(12:19):
surgical site infections?
Speaker 4 (12:21):
Sure.
So I'm not sure the termscience of care delivery is
widely used, but it's what weuse in our science department at
Blue Pearl.
So basically what we're lookingat is how can we take
evidence-based solutions andfind evidence-based solutions
for different care items that wetypically do in the hospital
(12:46):
setting, and so for minimizingnosocomial infections.
Obviously, as I alluded tobefore, there's other studies to
be done with the glass beaddisinfection device, but there's
also new technology on themarket that may be out of reach
financially for most practicesright now, but hopefully as the
technology improves there's moremarket competition, they'll be
(13:09):
more accessible to us.
The one that I think ofprimarily is the use of
ultraviolet wave technology fordisinfection.
So there are actually entireroom devices that will use
technology and a camera tovisualize all the surfaces, know
exactly the contours of theroom and it will use ultraviolet
(13:33):
technology to disinfect allsurfaces.
Right now we've got technicians,assistants, anybody scrubbing
the walls of isolation wards,the operating rooms, between
procedures, especially implantprocedures like total joint
replacements.
That's a lot of time, that's alot of money, it's a lot of
(13:54):
potential toxic exposure tofumes from those cleaning agents
and we're probably still doinga less effective job than this
single device could do, and sothose are kind of the next steps
, I think, in researching how wecan better prevent infection.
(14:14):
Obviously there are some whereit's just the transfer from the
clinical staff to the animal,and so there are options there
as well.
But if we're really looking atjust how can we better disinfect
and make sure that the bioburden around the hospital is
lower, I think that ultravioletlight is a really cool aspect
(14:35):
that we could focus on.
Speaker 2 (14:36):
Yeah, I really like the theme too of just like
enhancing the time that we havewith our technicians and really
just using our credentialtechnicians to the most that we
can.
So that's another great tool, Ithink, in that respect as well.
Speaker 3 (14:47):
Hey, kp, this was your resident project.
It's not easy to ever come upwith a really cool idea while
you're a busy resident.
Design it, get it done, get itwritten, get it published.
So well done you.
How did all of that trainingprepare you to write this
article?
Speaker 5 (15:04):
Yeah, so back in college I actually was a
microbiology teaching assistantfor several semesters, so
fortunately you have a littlebit of familiarity with things
like bacterial culture, plating,dilutions, things like that.
So that definitely came in handyfor the materials and methods
technical part of the study.
But definitely, you know, Ithink that is a challenge of any
(15:27):
residency requirement that doeshave a publication, because
that's not what I'm doingresearch on a daily basis.
So in regards to all the otheraspects of the research side, I
believe it was my first year ofresidency Blue Pearl actually
started a resident researchforum, kind of a weekend
conference, kind of the nittygritty about everything you need
(15:48):
to know, from developing ideato getting the manuscript
published to tips at presentingat conferences, and it's been a
really good resource for thosethat you know just don't have a
lot of previous clinicalresearch experience, myself
included, and I definitely couldhave not done this without my
residency program advisor, drZyla, who's also on the study,
(16:12):
and Stephen as well, especiallya lot of support when it came to
revising the manuscript andgoing through the review process
.
Speaker 2 (16:19):
So, stephen, this next set of questions is going
to be very important for ourlisteners, and the first one is
going to deal with theveterinary team.
So, stephen, what is one pieceof information the veterinary
team should know about thescience of care delivery?
Speaker 4 (16:45):
the best practice or the most efficient way to still
give great care, becauseultimately, that's our goal is
to give optimal care to ourpatients.
But I think that one thing thatwe may overlook is that this is
one time where the student orthe new assistant or technician
fresh out of school may reallybe the best contributor.
We that have been in practicefor many years have a lot of
(17:07):
training, have a lot ofexperience, tend not to think
outside the box as much.
I mean, we adopt new thingsthat are evidence-based, that
are in the literature, but wedon't necessarily think in
day-to-day oh I wonder if Itried this.
Whereas people that don't haveall of that baggage, as it were,
may be more likely to askquestions, though I worry that
(17:31):
they feel dumb about it.
So I really want to encouragethe whole team to realize that
there's no dumb question here.
By asking these questions, weget to find better ways to do
things and ultimately keepproviding great care, but maybe
make things so that they aremore approachable, more
affordable for clients, becauseright now we know that we're
(17:54):
currently we're we're quicklybecoming outpriced for for the
market and that's a realhardship on our, our clients,
and ultimately we want to beable to treat as many patients
as we can.
So keep asking those questions.
Nothing is dumb.
Throw it out there and look forthe evidence behind what you're
looking for.
Speaker 3 (18:14):
Stephen.
I love that.
I would say that in my 30 plusyears as a clinician scientist,
my best questions, meaning themost impactful for human and
veterinary medicine came frompeople that are like I have a
really dumb question.
It could have been a student, atechnician, a resident,
somebody in the sidelines aftera talk I have a really dumb
(18:34):
question.
And I was like, huh, actuallywe don't know if that's true,
that's a great question.
Speaker 2 (18:39):
So I concur, and Stephen on the other side of the
relationship.
What's one thing that clientsshould know about this topic?
Speaker 4 (18:47):
I would like our clients to know that we're doing
the best we can.
We are doing what the evidencetells us to do, because a lot of
these topics we don't have newor current or kind of best fit
evidence for every situation.
Things are changing so quicklyand the more that we can do
(19:10):
frankly, kind of simple studieslike this, the better we'll be
able to help them.
But in the meantime I just askfor their patience.
We are doing it.
I mean the same that I saidwith the students kind of new
techs, new assistants.
If a client has experience fromanother background that may
(19:31):
contribute, have them bring itup to you.
Feel free to talk to yourveterinarian about, or their
team about, how we mightapproach something differently
to make it more approachable forthe client side of things,
because we get wrapped up in themedicine and we don't always
look at it from that side.
So just have an open dialogue.
Speaker 3 (19:53):
Very funny, stephen.
Give us their patience.
Yeah Well, I have you.
As we wrap up, we like to ask alittle more of a light-sided
question.
Stephen, if you have it, youcan show us what is the oldest
or most interesting item on yourdesk or in your desk drawer.
Speaker 4 (20:10):
So not technically on my desk, it's on the bookshelf
behind me.
I've got this great picture ofa rabbit and it's actually made
by a former technician that Iworked with, who had been an
artist before coming to theveterinary field as so many of
us have multiple careers and hername is Cheryl Polcaro.
(20:31):
During her training, they werepracticing imaging, took an
x-ray of the neck and head of arabbit and then she used mixed
media to draw the shape of arabbit and the soft tissue
around the skull, and so it'sreally coming from an
orthopedics background.
I love it because I get to seethe skeleton but also appreciate
(20:53):
that it's a rabbit and see thekind of the inner workings, and
I think it's a really cool wayto use that image and not waste
that piece of kind of medicalhistory that we have there.
Speaker 3 (21:08):
Very cool.
And did you know, stephen, thatJabma Cover Art?
We prioritize art from theveterinary team, so
veterinarians, veterinarytechnicians, so we don't solicit
.
Well, I mean, lots ofveterinary technicians and
veterinarians have professionalart, but we prioritize it from
our own veterinary family.
Speaker 4 (21:28):
Okay, I will definitely put the word out to
her on that.
I think she would be honored tohave some of her art on the
cover there.
Speaker 3 (21:35):
Yeah, excellent KP for you.
What's your favorite animalfact?
Speaker 5 (21:39):
Yeah, so you're going to get a bonus because a
pertinent fact about me leadsinto my animal fact that it's
kind of polarizing.
But banana is my favorite, likecandy flavor, like banana Laffy
Taffy banana runts, which Iknow a lot of people hate banana
.
But I recently found out thechemical compound that is used
to create artificial bananaflavor is chemically identical
(22:03):
to one of the alarm pheromonesfor honeybees.
So caution to use educatedjudgment of where you enjoy your
banana flavored candy.
Don't make the bees angry.
Speaker 3 (22:16):
That's an awesome fact.
I love it and I'm definitelyallergic to ground bees, so I
will keep that in mind, becauseI love that nasty fake banana
flavor too.
Speaker 2 (22:26):
It's a good time of year, too, to share that fact.
I feel like this is the time ofyear where you see more bees
they're like coming out.
I was at a picnic and it wasjust the food was swarmed with
them.
I didn't eat any of the foodthere we eat.
Afterwards I was like I'm nottouching that.
Thank you, kp, for being herewith us this morning and also
for sharing your manuscript, too, with our AJVR readers.
Speaker 5 (22:45):
Thanks so much for inviting us.
We appreciate it.
Speaker 4 (22:47):
Yes, it was a great time.
Speaker 2 (22:54):
And to our listeners.
You can read Stephen and KP'sarticle on AJVR.
I'm Sarah Wright with LisaFortier.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
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