Gershkovich Grigory E, Tiedeken Nathan C, Hampton David, Budacki Ross, Samuel Solomon P, Saing Minn
Department of Orthopaedic Surgery, Einstein Medical Center, Philadelphia, PA.
J Orthop Trauma. 2016 Oct;30(10):e351-6. doi: 10.1097/BOT.0000000000000619.
The use of intraoperative fluoroscopy has become a routine and useful adjunct within orthopaedic surgery. However, the fluoroscopy machine may become an additional source of contamination in the operating room, particularly when maneuvering from the anterior-posterior position to the lateral position. Consequently, draping techniques were developed to maintain sterility of the operative field and surgeon. Despite a variety of methods, no studies exist to compare the sterility of these techniques specifically when the fluoroscopy machine is in the lateral imaging position. We evaluated the sterility of 3 c-arm draping techniques in a simulated operative environment. The 3 techniques consisted of a traditional 3-quarter sterile sheet attached to the side of the operative table, a modified clip-drape method, and a commercially available sterile pouch. Our study demonstrated that the traditional method poses a high risk for sterile field contamination, whereas the modified clip-drape method and commercially available sterile pouch kept floor contamination furthest from the surgical field. With the current data, we urge surgeons to use modified techniques rather than the traditional draping method.
术中透视的应用已成为骨科手术中一种常规且实用的辅助手段。然而,透视机可能会成为手术室额外的污染源,尤其是在从前后位转换到侧位时。因此,人们开发了铺巾技术以维持手术区域和外科医生的无菌状态。尽管有多种方法,但尚无研究专门比较这些技术在透视机处于侧位成像位置时的无菌情况。我们在模拟手术环境中评估了三种C型臂铺巾技术的无菌性。这三种技术包括附着在手术台一侧的传统四分之三无菌单、改良的夹式铺巾法以及一种市售的无菌袋。我们的研究表明,传统方法造成手术区域无菌污染的风险很高,而改良的夹式铺巾法和市售的无菌袋使地面污染离手术区域最远。基于目前的数据,我们敦促外科医生使用改良技术而非传统的铺巾方法。