Low surface contamination by cis/oxaliplatin during hyperthermic intraperitoneal chemotherapy (HIPEC)
1Occupational, Social and Environmental Medicine, Ludwig Maximilians University, Munich, Germany. Rudolf.Schierl@med.uni-muenchen.de
Summary
Platinum drug contamination in operating rooms during hyperthermic intraperitoneal chemotherapy (HIPEC) can be minimized. Using infusion bags, proper cleaning, and double gloves significantly reduces surface platinum levels, ensuring a safer environment.
Area of Science:
- Oncology
- Surgical Safety
- Environmental Health
Background:
- Platinum-based chemotherapy drugs are widely used in cancer treatment.
- Hyperthermic intraperitoneal chemotherapy (HIPEC) involves localized drug delivery, raising concerns about operating room contamination.
- Monitoring environmental contamination is crucial for patient and healthcare worker safety.
Purpose of the Study:
- To assess platinum drug contamination levels in the operating room during HIPEC procedures.
- To identify sources and factors contributing to platinum contamination.
- To provide recommendations for minimizing contamination.
Main Methods:
- Environmental wipe sampling of HIPEC devices and operating room floors across six German hospitals.
- Analysis of platinum concentrations in 151 surface samples and 45 glove samples from surgeons and perfusionists.
- Conducted during 19 HIPEC procedures.
Main Results:
- Detected a wide range of platinum concentrations on HIPEC devices and floors (0.07–110,000 pg/cm²).
- High contamination was observed on the regulation knob and reservoir, especially when using syringes for drug injection.
- Platinum levels on protective gloves varied (0.01–729 ng/pair).
Conclusions:
- Sporadic high platinum contamination can occur, but low surface loads are achievable.
- Key strategies for reducing contamination include using infusion bags over syringes, thorough device cleaning post-HIPEC, and wearing double gloves.
- Wipe sampling effectively documents surface contamination levels.
