A Comparison of Three C-Arm Draping Techniques to Minimize Contamination of the Surgical Field

Area of Science:

• Orthopaedic Surgery
• Infection Control
• Surgical Technology

Background:

• Intraoperative fluoroscopy (c-arm) is standard in orthopaedic surgery.
• C-arm manipulation, especially to lateral positions, risks operating room contamination.
• Existing draping techniques lack comparative sterility data for lateral c-arm use.

Purpose of the Study:

• To evaluate and compare the sterility of three c-arm draping techniques.
• To identify optimal methods for maintaining sterility during lateral fluoroscopy in simulated surgical environments.

Main Methods:

• Simulation of an operative environment to test draping techniques.
• Evaluation of three distinct c-arm draping methods: traditional 3-quarter sheet, modified clip-drape, and a commercial sterile pouch.
• Assessment of sterile field integrity and floor contamination levels.

Main Results:

• The traditional 3-quarter sterile sheet method showed a high risk of sterile field contamination.
• Both the modified clip-drape method and the commercial sterile pouch effectively minimized floor contamination.
• These modified techniques kept contamination furthest from the surgical field compared to the traditional method.

Conclusions:

• Modified c-arm draping techniques are superior to the traditional method for maintaining sterility.
• Surgeons should adopt modified clip-drape or commercial sterile pouch methods.
• Improved draping practices are essential for reducing infection risk in orthopaedic procedures using fluoroscopy.