Occupational, Social and Environmental Medicine, Ludwig Maximilians University, Munich, Germany.
Eur J Surg Oncol. 2012 Jan;38(1):88-94. doi: 10.1016/j.ejso.2011.10.009. Epub 2011 Oct 27.
The aim of this study was to evaluate contamination by platinum drugs in the operating room during hyperthermic intraperitoneal chemotherapy (HIPEC).
Environmental sampling of 151 wipe samples from surfaces on the HIPEC devices and operating room floors was performed for platinum in six German hospitals during 19 HIPEC procedures. Additionally, 45 wipe samples from surgeons' and perfusionists' protective gloves were analyzed.
Platinum concentrations from the HIPEC devices and operating room floors ranged from 0.07 to 110,000 pg/cm(2) (Median: 1.5 pg/cm(2)) with high contamination on the regulation knob and reservoir after HIPEC procedure, particularly when injecting the cytostatic drug into the reservoir via syringe. Samples from perfusionists' and surgeons' protective gloves ranged between 0.01 and 729 ng/pair.
Although sporadically high platinum concentrations on surfaces on the HIPEC device and operating room floor were detected, our study revealed that low surface loads are definitely possible and can be documented by wipe samples. Important factors for achieving low surface contamination are the use of infusion bags instead of syringes for injection of the cytostatic solution, careful cleaning of the device after HIPEC and wearing of two pairs of gloves.
本研究旨在评估在腹腔内热灌注化疗(HIPEC)期间手术室中铂类药物的污染情况。
在德国的六家医院中,对 19 例 HIPEC 手术过程中的 HIPEC 设备和手术室地板的 151 个表面擦拭样本进行了铂类物质的环境采样。此外,还分析了来自外科医生和灌注师防护手套的 45 个擦拭样本。
HIPEC 设备和手术室地板上的铂浓度范围为 0.07 至 110000pg/cm²(中位数:1.5pg/cm²),HIPEC 手术后调节旋钮和储液器污染严重,特别是通过注射器将细胞毒性药物注入储液器时。来自灌注师和外科医生防护手套的样本浓度在 0.01 至 729ng/副之间。
尽管在 HIPEC 设备和手术室地板表面偶尔会检测到高浓度的铂,但我们的研究表明,低表面负荷是完全有可能的,并可以通过擦拭样本来记录。实现低表面污染的重要因素是使用输液袋代替注射器注射细胞毒性溶液、HIPEC 后仔细清洁设备以及佩戴两副手套。