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Timing of C-arm drape contamination
Paul G Peters1, Richard T Laughlin, Ronald J Markert
1Department of Orthopedics, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA.
Background:
Surgical site infection remains a concern in orthopedic surgery, and contamination of C-arm covers is a potentially modifiable risk factor.
Methods:
A single-cohort study was conducted using 30 consecutive patients undergoing operative fracture fixation. Cultures were obtained from the C-arm cover after initial draping and every 20 min thereafter. The total number of persons in the operating room (person-hours/h of study time) and the number of door openings were recorded. The C-arm position changes and the time to contamination were monitored.
Results:
The median time from the start of the operation to contamination was 20 min. There was a 17% contamination rate on initial draping, 50% at 20 min, 57% at 40 min, and 80% by 80 min. The C-arms in five cases were not contaminated during the surgery. Time to contamination correlated significantly with lateral position changes (correlation [r]=0.64; p=0.003) but was not related to C-arm position changes (r=0.22; p=0.34), number of door openings (r=0.20; p=0.39), or person-hours/h (r=0.04; p=0.85).
Conclusions:
Contamination of the C-arm drape occurs often and early during surgery for orthopedic fractures. We recommend minimal contact with the C-arm to avoid contamination of the surgical field.
Insights
C-arm cover contamination is frequent and occurs early during orthopedic fracture surgeries. Minimizing C-arm contact is recommended to prevent surgical site infections.
Area of Science:
- Orthopedic Surgery
- Infection Control
- Medical Device Contamination
Background:
- Surgical site infections (SSIs) are a significant concern in orthopedic surgery.
- Contamination of C-arm covers presents a potentially modifiable risk factor for SSIs.
Purpose of the Study:
- To investigate the timing and factors influencing C-arm cover contamination during orthopedic fracture fixation surgeries.
Main Methods:
- A single-cohort study involved 30 patients undergoing operative fracture fixation.
- C-arm cover cultures were taken post-draping and every 20 minutes.
- Operating room traffic (person-hours) and door openings were recorded.
- C-arm position changes and time to contamination were monitored.
Main Results:
- The median time to contamination was 20 minutes.
- Initial drape contamination was 17%, rising to 50% at 20 min, 57% at 40 min, and 80% by 80 min.
- Lateral C-arm position changes significantly correlated with earlier contamination (r=0.64, p=0.003).
Conclusions:
- C-arm drape contamination is common and occurs early in orthopedic fracture surgeries.
- Minimal intraoperative contact with the C-arm is advised to reduce surgical field contamination.
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