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Contamination on C-arm drapes noted
Investigators recommend not touching the C-arm cover if possible and changing gloves if necessary.
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LAS VEGAS — C-arm drape contamination during fracture surgery occurs often and early in procedures, according to investigators.
“A rapid and significant rate of contamination of C-arm drapes was found,” Paul Peters, MD, said during his presentation at the American Academy of Orthopaedic Surgeons annual meeting. “Our recommendation: You should avoid touching the C-arm cover if possible. If surgeon manipulation is required, simply just changing your gloves could assist in decreasing contamination. Also, if the extremity requires contact directly with the C-arm, cover the image intensifier with either a sheet or towel prior. Lateral position changes raise the risk of contamination, and that should be monitored.”
Peters and colleagues studied the time-dependent contamination of large C-arm drapes during 30 consecutive fracture cases. Using sterile cotton swabs, the investigators obtained cultures from the top and side of image intensifier covers at the initial draping and every 20 minutes during surgery. They also monitored the number of people in the operating room and the number of door openings during each procedure.
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Image: Peters P |
They discovered a median survival time of 20 minutes and a 17% contamination rate at the initial draping and 80% contamination at 80 minutes.
“Time to contamination did not correlate with persons/hours of study time,” he said. “It had a minimal correlation with number of door openings and transitions into and out of the operative field, and a moderate correlation with changing into the lateral position.”
Thomas A. Malvitz, MD, a co-moderator for the session, asked why the investigators did not see a correlation between contamination and person hours.
“Maybe our power analysis was not done to indicate that,” Peters responded. “Maybe we needed more cases, but I do not have a great reason why we did not have that correlation.”
For more information:
- Thomas A. Malvitz, MD, can be reached at Orthopaedic Associates of Grand Rapids, 1111 Leffingwell NE Suite 100, Grand Rapids, MI 49525; 616-459-7101; e-mail: tmalvitz@oagr.com. He receives research/institutional support from DePuy.
- Paul Peters, MD, can be reached at Miami Valley Hospital, 30 E. Apple St., Suite 2200, Dayton, OH 45409; 937-248-7852; e-mail: paulpeters44@hotmail.com. He received an OTA resident research grant for the study.
Reference:
- Peters P, Laughlin RT, Manternach A, et al. Time of exposure to C-arm drape contamination. Paper #76. Presented at the American Academy of Orthopaedic Surgeons 76th Annual Meeting. Feb. 25-27, 2009. Las Vegas.