Department of Orthopaedic Surgery, California University of Science and Medicine, Colton, California, USA.
Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, California, USA.
ANZ J Surg. 2021 Jul;91(7-8):1455-1461. doi: 10.1111/ans.17013. Epub 2021 Jun 21.
The purpose of this study is to compare the sterility of three C-Arm draping techniques: the clip-drape, sterile pouch, and a novel drape tower method. We hypothesize that our novel technique will minimize floor contamination from reaching the surgical field while allowing the C-Arm machine to rotate between lateral and anterior-posterior positions more quickly.
Five trials consisting of rotating the C-Arm and simulating surgeon movement were run using each technique. Ultraviolet light illuminating melamine powder was used to represent floor contamination. Measurements of melamine powder encroachment on the drapes were taken using the top of the C-Arm in lateral position as the reference point. The time needed to assemble, deploy, and retract the C-Arm was measured for each technique. The gown, gloves, and mayo stand were also examined after each trial for contamination.
Compared to the clip drape, the drape tower prevented contamination from reaching the C-Arm by an additional 30.5 cm (95% confidence interval (CI): 17.0-43.9, P < 0.001). The drape tower had faster deployment and retraction times than both the clip drape (P < 0.001 and P < 0.001, respectively) and sterile pouch (P = 0.011 and P < 0.001, respectively). The clip drape and sterile pouch exhibited glove contamination in two (40%) simulations, while the drape tower showed no instances of contamination (P = 0.255).
The novel drape tower technique limits the encroachment of floor contamination onto sterile drapes. It should be considered as an alternative draping method for lower extremity surgery.
本研究旨在比较三种 C 臂覆盖技术的无菌性:夹式覆盖、无菌袋和新型覆盖塔方法。我们假设我们的新技术将最大限度地减少来自地面的污染进入手术区域,同时允许 C 臂机更快地在侧位和前后位之间旋转。
使用每种技术进行了五次试验,包括旋转 C 臂和模拟外科医生的移动。使用紫外线照射三聚氰胺粉末来代表地面污染。用侧位的 C 臂顶部作为参考点,测量三聚氰胺粉末侵入覆盖物的程度。测量每种技术组装、展开和收回 C 臂所需的时间。每次试验后还检查了手术服、手套和梅奥支架是否有污染。
与夹式覆盖相比,覆盖塔可使污染物距离 C 臂多 30.5cm(95%置信区间(CI):17.0-43.9,P<0.001)。覆盖塔的展开和收回时间均快于夹式覆盖(P<0.001 和 P<0.001)和无菌袋(P=0.011 和 P<0.001)。夹式覆盖和无菌袋在两次(40%)模拟中显示手套污染,而覆盖塔没有污染实例(P=0.255)。
新型覆盖塔技术限制了地面污染侵入无菌覆盖物。它应被视为下肢手术的替代覆盖方法。