Jernigan Edward W, Smetana Brandon S, Rummings Wayne A, Dineen Hannah A, Patterson J Megan M, Draeger Reid W
Department of Orthopaedics, University of North Carolina, Chapel Hill, North Carolina, United States.
J Hand Microsurg. 2020 Apr;12(1):3-7. doi: 10.1055/s-0038-1674297. Epub 2018 Sep 28.
The aim of this study was to quantify the effect of surgical gown and glove wear on carpal tunnel pressure. The authors hypothesized that gowning and gloving is associated with an increase in carpal tunnel pressure in cadaveric specimens wearing appropriately sized gloves. Furthermore, they hypothesized that increased glove thickness, double gloving, and smaller-than-appropriately sized gloves would all serve to increase carpal tunnel pressure. Baseline carpal tunnel pressure measurements were obtained in 11 cadaveric specimens. Each specimen was subsequently gowned and gloved. Carpal tunnel pressures were obtained for each specimen fitted with four different types of gloves in four scenarios: (1) appropriately sized gloves, (2) one full-size smaller, (3) one full-size larger, and (4) double gloved. Mean carpal tunnel baseline value was 3.5 mm Hg. Appropriately sized single-glove wear more than doubled baseline carpal tunnel pressure. Double gloving and smaller-than-appropriately sized glove wear more than tripled baseline values. Among the single-glove subgroup, the thickest gloves (ortho) were associated with the highest increase in pressure from baseline values. Glove selection can have repercussions related to carpal tunnel pressure. Susceptible surgeons should consider these factors when making decisions regarding intraoperative glove wear.
本研究的目的是量化手术衣和手套穿戴对腕管压力的影响。作者假设,对于佩戴尺寸合适手套的尸体标本,穿上手术衣和戴上手套会使腕管压力升高。此外,他们还假设,手套厚度增加、戴双层手套以及手套尺寸小于合适尺寸都会导致腕管压力升高。在11个尸体标本上获取了腕管压力的基线测量值。随后,为每个标本穿上手术衣并戴上手套。在四种情况下,为每个佩戴四种不同类型手套的标本测量腕管压力:(1)尺寸合适的手套;(2)小一号的手套;(3)大一号的手套;(4)双层手套。腕管压力基线平均值为3.5毫米汞柱。佩戴尺寸合适的单手套使腕管压力基线值增加了一倍多。戴双层手套以及佩戴尺寸小于合适尺寸的手套使基线值增加了两倍多。在单手套亚组中,最厚的手套(矫形手套)导致压力相对于基线值升高幅度最大。手套的选择可能会对腕管压力产生影响。易受影响的外科医生在做出术中手套穿戴的决策时应考虑这些因素。