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Volume 39, Issue 2

Original Article

Effect of QR Code Marking of Surgical Instruments on Sterilization Processes and the Incidence of Surgical Site Infection

Mustafa İnan
Affiliations
  • Trakya Üniversitesi Tıp Fakültesi, Çocuk Cerrahisi Anabilim Dalı, Edirne, Türkiye
https://orcid.org/0000-0001-8315-4328
,
Abdullah Taş
Affiliations
  • Trakya Üniversitesi Tıp Fakültesi, Kulak Burun ve Boğaz Hastalıkları Anabilim Dalı, Edirne, Türkiye
https://orcid.org/0000-0002-5689-087X
,
Hüseyin Güdücüoğlu
Affiliations
  • Trakya Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Edirne, Türkiye
https://orcid.org/0000-0003-1101-9017
,
Zerrin Yuluğkural
Affiliations
  • Trakya Üniversitesi Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Edirne, Türkiye
https://orcid.org/0000-0002-0813-0403
,
Necdet Süt
Affiliations
  • Trakya Üniversitesi Tıp Fakültesi, Biyoistatistik ve Tıbbi Bilişim Anabilim Dalı, Edirne, Türkiye
https://orcid.org/0000-0001-6678-482X
  • cerrahi alan infeksiyonu
  • color coding
  • QR code
  • sterilization
  • Surgical instruments
  • surgical site infection
  • surgicalsite infection

Abstract

Objective: This study aimed to evaluate the effect of marking surgical instruments with laser-engraved QR codes instead of conventional color coding on error rates in central sterilization processes, microbial contamination, and the incidence of surgical site infection (SSI).

Methods: This prospective study was conducted at Trakya University Health Research and Application Hospital between November 2024 and May 2025. A total of 225 surgical sets comprising approximately 10,000 surgical instruments were evaluated. During the color code and QR code periods, data were collected using questionnaire administered to operating room and central sterilization unit personnel, SSI surveillance data, microbiological samples obtained from surgical instruments, and operating room and sterilization tracking forms. Statistical analyses were performed using the Shapiro-Wilk test, paired t-test, Wilcoxon signed-rank test, and McNemar’s chi-square test.

Results: The incidence of SSI decreased after the QR code system was implemented, but the reduction was not statistically significant (p>0.05). The rate of microbial growth in surgical sets dropped from 19.1% before QR code implementation to 3.1% after implementation (p<0.001). Coagulase-negative staphylococci were the most frequently isolated microorganisms. Error rates fell from 6% to 3% in the central sterilization unit and from 2.6% to 1.4% in the operating room (p<0.001). Overall, 93% of participants reported confidence in the QR code system. However, a delay in delivering surgical sets to the operating room was observed after QR code implementation.

Conclusion: Marking surgical instruments with QR codes reduces error rates in sterilization processes, decreases microbial contamination, and facilitates instrument traceability. Although the reduction in SSI incidence was not statistically significant, the QR code system may contribute positively to infection control and process management. The observed delay in delivering surgical sets to the operating room underscores the need for careful process planning during system implementation.

Keywords: Surgical instruments, color coding, QR code, sterilization, surgical site infection

  • 91–8
  • Mustafa İnan
  • [email protected]
  • 10.36519/kd.2026.5378
  • September 5, 2025
  • February 24, 2026
  • June 29, 2026
  • 13
  • 3
Download as PDF
  • This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. CC BY-NC
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