Veterinary Vertex
Veterinary Vertex is a weekly podcast that takes you behind the scenes of the clinical and research discoveries published in the Journal of the American Veterinary Medical Association (JAVMA) and the American Journal of Veterinary Research (AJVR). Tune in to learn about cutting-edge veterinary research and gain in-depth insights you won’t find anywhere else. Come away with knowledge you can put to use in your own practice – along with a healthy dose of inspiration to remind you what you love about veterinary medicine.
Veterinary Vertex
Rapid Disinfection in Busy Veterinary Clinics: The Glass Bead Method
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!
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Open access AJVR article: https://doi.org/10.2460/ajvr.25.04.0123
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Speaker 2:You're listening to Veterinary Vertex, a podcast of the AVMA Journals. In this episode, we chat about how a thermal glass bead device provides an effective method of rapid disinfection of suture scissor blades in a veterinary environment, with our guests Stephen Frederick and KP Spidey.
Speaker 3:Welcome listeners. I'm Editor-in-Chief Lisa Fortier, and I'm joined by Associate Editor Sarah Wright. Today we have Stephen and KP joining us. Thank you guys so much, during this 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:Yeah, thank you for having us.
Speaker 2:All right, let's dive right in. So, kp, your AJBR article discusses how glass bead disinfection may be a more efficient and cost-effective alternative to true sterilization for lowering the risks of cross-contamination associated with the use of suture scissors in a veterinary setting. Please share with our listeners the background on this article.
Speaker 5:Yeah. So whenever we close an incision, commonly if it's something that's a large incision or there's a lot of tension, we'll often place true skin sutures versus an intradermal closure that we remove once that incision's healed. To that we use suture scissors. The challenge of that is, when used, these suture scissors are in direct contact with both that suture material but commonly the patient's skin. If you're like my dog, you've already regrown your fur next to that incision and so there's a potential for bacterial contamination. And in an ideal world every pair of scissors would be sterilized between patients. But in a busy clinical environment that often just isn't very practical.
Speaker 5:Sterilization requires time. You know equipment of the autoclave and you have to have an instrument inventory to rotate through to have one available for every patient. So as a result, in many practices I think we use suture scissors with varying degrees of cleaning and disinfection between them, and I think, just as a matter of convenience. But unfortunately this does create a risk for cross-contamination, especially with considering, unfortunately nowadays, how common multidrug-resistant bacteria are in veterinary hospital settings. So class B disinfection has historically been used in other fields like dentistry and particularly in lab animal medicine as a quick way to disinfect instrument tips medicine as a quick way to disinfect instrument tips. It's important to know that it's not the same as full sterilization, but it can substantially reduce bacterial load in a fraction of the time. So we wanted to take a look at this specifically towards the application of suture removal scissors in veterinary medicine, particularly for healed surgical sites where we anticipated our bacterial load to be pretty low.
Speaker 2:Yeah, what a cool study, and people, too, on social media are definitely talking about it as well. We did a promotional post and it was cool to see the conversation of people being like wow, that would really help in my clinic. We're so busy. This would be great ways for us to implement this. So thank you for sharing that, too, with our readers.
Speaker 5:Yeah for sure I know, being a surgical resident, we could have anywhere from you know, eight to 12 suture removal appointments in a day. So definitely something that having a quicker option is definitely there's a need, oh for sure and KP.
Speaker 2:what are the important take-home messages from this article?
Speaker 5:Yeah, I think the most important takeaway is that it worked, and not only that it worked, that it worked consistently. I think that was kind of something that I think is the main takeaway of this study, because in the pre-disinfection samples about a third had clinically relevant bacterial growth, including some kind of really nasty multi-drug resistant organisms, and just 60 seconds with that glass bead disinfection, none of the scissors had detectable growth on the post-disinfection samples. So again, that sterilization is always going to be the gold standard. This isn't going to replace that. You know you still have got to put your full instrument packs through scrub and autoplay of sterilization. But for something where your bacterial load is expected to be relatively low, like in healed incisions, this could be a really useful application. And I think ultimately, the bottom line takeaway is that this is about seeing practicality with patient safety, and I think it's something that's a pretty low investment in terms of cost, time, training. Anyone can do this to overall improve patient care Very cool, stephen, over to you.
Speaker 3:What sparked your interest in studying this? Were you at the dentist and saw how they were doing it quickly? Or just thinking that's nasty, that we're using the same suture scissors and just wiping them with alcohol or what? What? What sparked your like, hey, we should look at this. How do you even find out about the glass bead sterilization method?
Speaker 4:yeah, so I. I've been a credentialed technician with a specialty in surgery for over 15 years, and so in surgical site infections are a pretty consistent part of my life. Unfortunately, in our practice we actually in our ophthalmology suite where they're doing some things like eyelid mass removals that are not necessarily invasive and are fairly low risk for infection and contamination. They actually had this device in there, and that's where I first found out about it, and over the years I just kept thinking there's got to be something that we can be doing with this machine to help the rest of the surgery department. It's not just for eyelid mass removals. I knew that they use them in dentistry.
Speaker 4:Ooh, this would be a really great way for us to disinfect our suture scissors, our bandage scissors, things like that. Obviously, we didn't test bandage scissors in this case, but it was next on my list. Suture scissors just seemed more feasible and applicable. But really just the goal of limiting contamination while also bringing up efficiency. We as technicians are asked to do a lot of things, including the cleaning and sterilizing of those instruments, and knowing that I could be contributing more to patient care if I didn't have to spend all that time sterilizing 15 pairs of scissors a day was really a big seller for me, as well as just the environmental impact of all of our surgical waste in a daily basis. If we're not having to open and throw away sometimes double-packed peel pouches, that's a lot of waste per year that we can avoid, and so there were quite a number of reasons that this kind of rang true to me.
Speaker 3:That's a fantastic point, stephen. You know that would be actually a really great article to do to say this is the people cost and the environmental cost to sterilization. And then, as you said, you need to own 15 pair like 15 mini packs, right, you have to have 15 mini packs of Brown-Adson or whatever. You use rat tooth and the suture removal scissor. And that's people, right? People, as you know, are the most expensive time and we don't want our veterinarians or our technicians doing things like packing when they could be doing enhancing patient care. So that would be a really, you know, an environmental survey of what you're saving there as well. Very, very cool. While I have you, stephen, as I just I mean, you need suture, you need some type of forcep too, a brown adson or a rat tooth or something. Did you look at that too, or is that coming for us next?
Speaker 4:We did not. We chose to focus just on the suture blades because this was a resident project. We wanted to make it very achievable, very directly relatable, so we focused on a single instrument instead of bringing in other potential holdups or confounders. I think that it's a really great point that a suture removal is not a single instrument procedure and we do need to extrapolate this into other stainless steel heatable instruments that we could do this with. I mean, just bandage scissors are a big one for me, because we've all seen a really nasty wound bandage that's used. Somebody wipes it down with alcohol gauze and then puts the scissors in their pocket again. Even something like a stylet or a specula could be other alternative studies that we should be looking at, because there's a lot of instruments that we use in daily practice, whether in surgery or medicine or emergency, that could really benefit from these types of disinfection protocols where we're just not being efficient or we're putting the active patient care over the kind of passive patient care.
Speaker 3:Well said, KP. Earlier Sarah asked you what were the important take-home messages. But every time we do any sort of 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 the surprising findings for you and Stephen in this article?
Speaker 5:Yeah, I think kind of two things. One, reiterating on that main highlight is just the effectiveness of this instrument, especially against the wide range of bacteria that we're seeing. And I think that was another aspect that I found interesting is, you know, even though it was about a third, still a pretty significant portion, I would say, of healed incisions. You know, carry that bacteria flora around that incision and I think it may help explain anecdotally sometimes why we see a patient. You know, at that 10 to 14 day mark that that incision is healed, we give the owner the okay to start to bathe, back in normal activity, remove that cone and then start to have complications and problems with the incision.
Speaker 5:I think sometimes we forget that. You know we try to create as aseptic of an environment at the time of surgery, but that's temporary. 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 a variety of bacteria that played a role here. Bacteria that played a role here and I think also kind of extrapolating it a little bit, goes to show the importance of glove wearing, hand washing between handling patients for any reasons you just don't know kind of what bacteria are going to be present, and making sure that we don't spread that between patients, because what may not cause a problem for one patient could potentially present a problem to another patient.
Speaker 2:Yeah, I feel like hand washing is a big theme of our podcast episodes lately. We used to do one on salmonella and they were like talking about how long salmonella can live on like picnic tables. It was horrifying to learn that. So please wash your hands if you're listening to this. It applies in a variety of settings. So, Stephen, what are the next steps to research into the science of care delivery as it relates to minimizing nosocomial surgical site infections?
Speaker 4:Sure. So I'm not sure the term science of care delivery is widely used, but it's what we use in our science department at Blue Pearl. So basically what we're looking at is how can we take evidence-based solutions and find evidence-based solutions for different care items that we typically do in the hospital setting, and so for minimizing nosocomial infections. Obviously, as I alluded to before, there's other studies to be done with the glass bead disinfection device, but there's also new technology on the market that may be out of reach financially for most practices right now, but hopefully as the technology improves there's more market competition, they'll be more accessible to us. The one that I think of primarily is the use of ultraviolet wave technology for disinfection. So there are actually entire room devices that will use technology and a camera to visualize all the surfaces, know exactly the contours of the room and it will use ultraviolet technology to disinfect all surfaces.
Speaker 4:Right now we've got technicians, assistants, anybody scrubbing the walls of isolation wards, the operating rooms, between procedures, especially implant procedures like total joint replacements. That's a lot of time, that's a lot of money, it's a lot of potential toxic exposure to fumes from those cleaning agents and we're probably still doing a less effective job than this single device could do, and so those are kind of the next steps, I think, in researching how we can better prevent infection. Obviously there are some where it'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 at just how can we better disinfect and make sure that the bio burden around the hospital is lower, I think that ultraviolet light is a really cool aspect that we could focus on.
Speaker 2:Yeah, I really like the theme too of just like enhancing the time that we have with our technicians and really just using our credential technicians to the most that we can. So that's another great tool, I think, in that respect as well.
Speaker 3:Hey, kp, this was your resident project. It's not easy to ever come up with a really cool idea while you're a busy resident. Design it, get it done, get it written, get it published. So well done you. How did all of that training prepare you to write this article?
Speaker 5:Yeah, so back in college I actually was a microbiology teaching assistant for several semesters, so fortunately you have a little bit of familiarity with things like bacterial culture, plating, dilutions, things like that.
Speaker 5:So that definitely came in handy for the materials and methods technical part of the study. But definitely, you know, I think that is a challenge of any residency requirement that does have a publication, because that's not what I'm doing research on a daily basis. So in regards to all the other aspects of the research side, I believe it was my first year of residency Blue Pearl actually started a resident research forum, kind of a weekend conference, kind of the nitty gritty about everything you need to know, from developing idea to getting the manuscript published to tips at presenting at conferences, and it's been a really good resource for those that you know just don't have a lot of previous clinical research experience, myself included, and I definitely could have not done this without my residency program advisor, dr Zyla, who's also on the study, and Stephen as well, especially a lot of support when it came to revising the manuscript and going through the review process.
Speaker 2:So, stephen, this next set of questions is going to be very important for our listeners, and the first one is going to deal with the veterinary team. So, stephen, what is one piece of information the veterinary team should know about the science of care delivery?
Speaker 4:the best practice or the most efficient way to still give great care, because ultimately, that's our goal is to give optimal care to our patients. But I think that one thing that we may overlook is that this is one time where the student or the new assistant or technician fresh out of school may really be the best contributor. We that have been in practice for many years have a lot of training, have a lot of experience, tend not to think outside the box as much. I mean, we adopt new things that are evidence-based, that are in the literature, but we don't necessarily think in day-to-day oh I wonder if I tried this.
Speaker 4:Whereas people that don't have all of that baggage, as it were, may be more likely to ask questions, though I worry that they feel dumb about it. So I really want to encourage the whole team to realize that there's no dumb question here. By asking these questions, we get to find better ways to do things and ultimately keep providing great care, but maybe make things so that they are more approachable, more affordable for clients, because right now we know that we're currently we're we're quickly becoming outpriced for for the market and that's a real hardship on our, our clients, and ultimately we want to be able to treat as many patients as we can. So keep asking those questions. Nothing is dumb. Throw it out there and look for the evidence behind what you're looking for.
Speaker 3:Stephen. I love that. I would say that in my 30 plus years as a clinician scientist, my best questions, meaning the most impactful for human and veterinary medicine came from people that are like I have a really dumb question. It could have been a student, a technician, a resident, somebody in the sidelines after a talk I have a really dumb question. And I was like, huh, actually we don't know if that's true, that's a great question.
Speaker 2:So I concur, and Stephen on the other side of the relationship. What's one thing that clients should know about this topic?
Speaker 4:I would like our clients to know that we're doing the best we can. We are doing what the evidence tells us to do, because a lot of these topics we don't have new or current or kind of best fit evidence for every situation. Things are changing so quickly and the more that we can do frankly, kind of simple studies like this, the better we'll be able to help them. But in the meantime I just ask for their patience. We are doing it. I mean the same that I said with the students kind of new techs, new assistants. If a client has experience from another background that may contribute, have them bring it up to you. Feel free to talk to your veterinarian about, or their team about, how we might approach something differently to make it more approachable for the client side of things, because we get wrapped up in the medicine and we don't always look at it from that side. So just have an open dialogue.
Speaker 3:Very funny, stephen. Give us their patience. Yeah Well, I have you. As we wrap up, we like to ask a little more of a light-sided question. Stephen, if you have it, you can show us what is the oldest or most interesting item on your desk or in your desk drawer.
Speaker 4:So not technically on my desk, it's on the bookshelf behind me. I've got this great picture of a rabbit and it's actually made by a former technician that I worked with, who had been an artist before coming to the veterinary field as so many of us have multiple careers and her name is Cheryl Polcaro. During her training, they were practicing imaging, took an x-ray of the neck and head of a rabbit and then she used mixed media to draw the shape of a rabbit and the soft tissue around the skull, and so it's really coming from an orthopedics background. I love it because I get to see the skeleton but also appreciate that it's a rabbit and see the kind of the inner workings, and I think it's a really cool way to use that image and not waste that piece of kind of medical history that we have there.
Speaker 3:Very cool. And did you know, stephen, that Jabma Cover Art? We prioritize art from the veterinary team, so veterinarians, veterinary technicians, so we don't solicit. Well, I mean, lots of veterinary technicians and veterinarians have professional art, but we prioritize it from our own veterinary family.
Speaker 4:Okay, I will definitely put the word out to her on that. I think she would be honored to have some of her art on the cover there.
Speaker 3:Yeah, excellent KP for you. What's your favorite animal fact?
Speaker 5:Yeah, so you're going to get a bonus because a pertinent fact about me leads into my animal fact that it's kind of polarizing. But banana is my favorite, like candy flavor, like banana Laffy Taffy banana runts, which I know a lot of people hate banana. But I recently found out the chemical compound that is used to create artificial banana flavor is chemically identical to one of the alarm pheromones for honeybees. So caution to use educated judgment of where you enjoy your banana flavored candy. Don't make the bees angry.
Speaker 3:That's an awesome fact. I love it and I'm definitely allergic to ground bees, so I will keep that in mind, because I love that nasty fake banana flavor too.
Speaker 2:It's a good time of year, too, to share that fact. I feel like this is the time of year where you see more bees they're like coming out. I was at a picnic and it was just the food was swarmed with them. I didn't eat any of the food there we eat. Afterwards I was like I'm not touching that. Thank you, kp, for being here with us this morning and also for sharing your manuscript, too, with our AJVR readers.
Speaker 5:Thanks so much for inviting us. We appreciate it.
Speaker 4:Yes, it was a great time.
Speaker 2:And to our listeners. You can read Stephen and KP's article on AJVR. I'm Sarah Wright with Lisa Fortier. Be on the lookout for next week's episode and don't forget to leave us a rating and review on Apple Podcasts or whatever platform you listen to.
