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The Silent Culprit: Foot Pedals and Surgical Site Infections

In the operating room, where precision and sterility are paramount, every potential source of contamination demands attention. While rigorous protocols are in place to minimize infection risks, a silent culprit often goes unnoticed: foot pedals. These devices for activating surgical instruments may unwittingly contribute to surgical site infections (SSIs), compromising patient outcomes, burdening hospital resources, and increasing healthcare costs. In this blog post, we shed light on the role of foot pedals in contamination, discuss the impact of SSIs, and present compelling evidence emphasizing the need to address foot pedal-related risks.

Foot Pedals: An Overlooked Source of Contamination

Foot pedals have long been employed to control various surgical instruments during procedures. Surgeons and medical professionals use their feet to activate these devices, allowing for hands-free control and focus. However, foot pedals can accumulate pathogens and act as potential reservoirs of contamination. Despite their essential role in the operating room, infection control protocols often overlook foot pedals. However, these devices have unique characteristics:

  1. They are routinely placed under the operative field.

  2. They are exposed to multiple bodily fluids.

  3. They are not waterproof, so they cannot be cleaned thoroughly.

  4. Despite manufacturers' recommendation to cover foot pedals in clear plastic before each surgery, this rarely happens.

  5. Despite the above, they are frequently handled by OR personnel without gloves.

  6. Bipolar forceps foot pedals require OR staff handling during surgery more than two times per case, on average, according to our survey data. During surgery, staff must crawl under the operating table to move the bipolar foot pedal, often because the surgeon needs to coagulate active bleeding. Often, they will do so without wearing gloves. Manipulation of foot pedals can contribute to airborne contaminants and OR contamination by staff who usually do not wash their hands after moving the foot pedals.

The Impact of Surgical Site Infections

Surgical site infections are a serious concern, as they can lead to increased morbidity, prolonged hospital stays, readmissions, and even mortality. These complications harm patients, strain hospital resources, and increase healthcare costs. Preventing SSIs is crucial for enhancing patient safety, improving outcomes, and reducing the financial burden on healthcare systems.

Compelling Statistics and Case Studies

We conducted a study to evaluate the presence of pathogens on bipolar forceps foot pedals. The results revealed the presence of various bacteria, including Coliform pathogenic strains, highlighting the potential risk of contamination associated with foot pedals.

Addressing the Foot Pedal Contamination Risk

Recognizing the importance of infection prevention, healthcare facilities must take proactive measures to address foot pedal contamination risks. Here are some recommended strategies:

  1. Regular Cleaning and Disinfection: Implement strict protocols for cleaning and disinfecting foot pedals after each use. Use appropriate disinfectants that effectively target pathogens without compromising the device's functionality.

  2. Single-Use Disposable Covers: Consider using single-use disposable covers for foot pedals. These covers can be easily replaced after each procedure, minimizing the risk of cross-contamination between patients.

  3. Alternative Activation Mechanisms: Explore alternative mechanisms for instrument activation that reduce or eliminate the need for foot pedals. Hand-switching devices, like the BiPad, allow surgeons to control bipolar forceps electrosurgery units without relying on foot pedals, thereby reducing the potential for contamination.


In the quest for safer surgeries and improved patient outcomes, it is essential to address all potential sources of contamination in the operating room. Foot pedals, though often overlooked, harbor pathogens and contribute to surgical site infections. By recognizing the risks associated with foot pedal contamination and implementing appropriate measures such as regular cleaning, disposable covers, and alternative activation mechanisms, healthcare facilities can significantly minimize SSIs, enhance patient safety, and reduce healthcare costs. We must remember the power of meticulous infection control in preserving lives and ensuring successful surgical outcomes.

BiPAD provides the ultimate solution by obviating the need for foot pedals for bipolar forceps activation. Hand-switching is the standard for all other forms of electrosurgery; it should be for bipolar forceps.


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