From the Department of Anesthesiology, Baylor Scott & White Medical Center, The Texas A&M University System Health Science Center College of Medicine, Temple, TX.
J Patient Saf. 2021 Dec 1;17(8):e1846-e1850. doi: 10.1097/PTS.0000000000000665.
The aim of the study was to measure underdrape oxygen pooling, surgical site oxygen contamination, and time to restoration of 21% oxygen concentration after cessation of oxygen delivery by measuring oxygen concentration under simulated clinical conditions with various drapes.
In a 2-part study, oxygen permeability of four differing surgical drapes was measured (Part A) and a mannequin was used to measure underdrape oxygen pooling and surgical site oxygen contamination (Part B). In Part A, a container of high concentration oxygen was sealed with a surgical drape. Oxygen concentrations on both sides of the drape were then measured over time to quantify drape oxygen permeability. Part B included a mannequin model draped for a hypothetical surgical site with oxygen administered by face mask. Oxygen concentration was measured at both the surgical site and under the drape nearest the surgical site.
Oxygen permeability varied significantly between drapes tested. The surgical site oxygen concentration ranged from 20% to 58% (P = 0.0001). The commonly used woven 100% cotton operating room (OR) towel was highly permeable. The plastic occlusive drape created an impermeable barrier, which did not allow for any oxygen contamination but created the longest time to return to 21% oxygen concentration at the underdrape site after cessation of oxygen delivery.
Surgical drapes have varying oxygen permeability and can lead to high concentration underdrape oxygen pooling. Oxygen contamination of the surgical site varies widely based on drape material and may reach dangerously high levels, especially with the cotton OR towel. Surgical drape selection may impact OR fire risk.
本研究旨在通过测量模拟临床条件下各种手术巾下的氧气浓度，来测量覆盖层下的氧气积聚、手术部位的氧气污染以及停止供氧后恢复 21%氧气浓度的时间。
在一项两部分的研究中，测量了四种不同手术巾的氧气透过率（第 A 部分），并使用模型来测量覆盖层下的氧气积聚和手术部位的氧气污染（第 B 部分）。在第 A 部分中，一个高浓度氧气容器用手术巾密封。然后，测量覆盖物两侧的氧气浓度随时间的变化，以量化覆盖物的氧气透过率。第 B 部分包括一个模型，该模型覆盖了一个假设的手术部位，并通过面罩供氧。在手术部位和离手术部位最近的覆盖物下测量氧气浓度。
测试的手术巾之间的氧气透过率有显著差异。手术部位的氧气浓度范围为 20%至 58%（P=0.0001）。常用的 100%纯棉手术巾渗透性很强。塑料密闭巾形成了一个不可渗透的屏障，不允许任何氧气污染，但在停止供氧后，覆盖物下回到 21%氧气浓度的时间最长。
手术巾的氧气透过率不同，可能导致覆盖层下的氧气积聚浓度较高。手术部位的氧气污染因覆盖物材料而异，可能达到非常高的水平，尤其是使用纯棉手术巾。手术巾的选择可能会影响手术室的火灾风险。
