Martin Dennis P, Chapman Talia, Williamson Christopher, Tinsley Brian, Ilyas Asif M, Wang Mark L
1 Department of Orthopedic Surgery, The Rothman Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Hand (N Y). 2019 Jul;14(4):565-569. doi: 10.1177/1558944717743600. Epub 2017 Nov 22.
This study aims to test the hypothesis that: (1) radiation exposure is increased with the intended use of Flat Surface Image Intensifier (FSII) units above the operative surface compared with the traditional below-table configuration; (2) this differential increases in a dose-dependent manner; and (3) radiation exposure varies with body part and proximity to the radiation source. A surgeon mannequin was seated at a radiolucent hand table, positioned for volar distal radius plating. Thermoluminescent dosimeters measured exposure to the eyes, thyroid, chest, hand, and groin, for 1- and 15-minute trials from a mini C-arm FSII unit positioned above and below the operating surface. Background radiation was measured by control dosimeters placed within the operating theater. At 1-minute of exposure, hand and eye dosages were significantly greater with the flat detector positioned above the table. At 15-minutes of exposure, hand radiation dosage exceeded that of all other anatomic sites with the FSII in both positions. Hand exposure was increased in a dose-dependent manner with the flat detector in either position, whereas groin exposure saw a dose-dependent only with the flat detector beneath the operating table. These findings suggest that the surgeon's hands and eyes may incur greater radiation exposure compared with other body parts, during routine mini C-arm FSII utilization in its intended position above the operating table. The clinical impact of these findings remains unclear, and future long-term radiation safety investigation is warranted. Surgeons should take precautions to protect critical body parts, particularly when using FSII technology above the operating with prolonged exposure time.
（1）与传统的手术台下方配置相比，在手术表面上方使用平面影像增强器（FSII）装置时，辐射暴露会增加；（2）这种差异呈剂量依赖性增加；（3）辐射暴露随身体部位和与辐射源的距离而变化。一名外科模拟人坐在一张可透射线的手术台上，准备进行桡骨远端掌侧钢板固定术。热释光剂量计测量了在手术表面上方和下方放置的小型C型臂FSII装置进行1分钟和15分钟试验时，眼睛、甲状腺、胸部、手部和腹股沟的辐射暴露情况。背景辐射通过放置在手术室内的对照剂量计进行测量。在暴露1分钟时，将平板探测器置于手术台上方时，手部和眼睛的剂量明显更高。在暴露15分钟时，无论FSII处于何种位置，手部的辐射剂量均超过所有其他解剖部位。无论平板探测器处于何种位置，手部暴露均呈剂量依赖性增加，而腹股沟暴露仅在手术台下方的平板探测器时呈剂量依赖性增加。这些发现表明，在手术台上方按预期位置常规使用小型C型臂FSII期间，与其他身体部位相比，外科医生的手部和眼睛可能会受到更大的辐射暴露。这些发现的临床影响尚不清楚，未来有必要进行长期的辐射安全调查。外科医生应采取预防措施保护关键身体部位，尤其是在手术台上方使用FSII技术且暴露时间较长时。
