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Airborne particle dynamics during draping of a surgical microscope versus an exoscope in spinal surgery: A
Yuki Umeno1, Eiji Abe2, Takeshi Hara2
1Nursing Division, [Operating Room], Juntendo University Hospital, Japan.
Background:
Exoscopes provide ergonomic and visualization advantages over conventional surgical microscopes. Despite their growing adoption, the impact of device draping on transient airborne particulate generation during setup, a critical but understudied contributor to surgical site contamination, remains unclear.
Methods:
This prospective observational study compared airborne particle dynamics during draping of a surgical microscope (Pentero) and an exoscope (Orbeye) in ten spinal surgeries (five per group) conducted in a laminar airflow operating room with high-efficiency particulate air filtration. Airborne particles sized 0.5 μm and 1.0 μm were recorded at 5 s intervals for 1 min from drape initiation. Cumulative exposure was analyzed using the area under the curve (AUC), and temporal dispersion patterns were analyzed using linear mixed-effects models.
Results:
Cumulative airborne particle exposure did not differ significantly between devices for either 0.5 μm or 1.0 μm particles, although 0.5 μm AUC values tended to be lower with the exoscope. Time-resolved analysis demonstrated a significant time-by-device interaction for 0.5 μm particles (p = 0.039), with lower particle counts observed with the exoscope at drape initiation. This device-dependent transient behavior was not observed for larger particles (1.0 μm).
Conclusion:
Transient airborne particle behavior during draping appears to be influenced by device configuration and draping mechanics rather than cumulative exposure alone. Awareness of device-specific airflow interactions and controlled draping practices may help mitigate transient contamination risk and enhance intraoperative environmental safety.
Insights
Exoscope draping generated fewer airborne particles initially compared to surgical microscopes, suggesting device setup influences contamination risk. Controlled draping practices can enhance operating room safety.
Area of Science:
- Surgical technology
- Operating room environmental monitoring
- Infection control
Background:
- Exoscopes offer ergonomic and visualization benefits over traditional surgical microscopes.
- The impact of device draping on airborne particle generation during setup is understudied.
- Airborne particles are a potential source of surgical site contamination.
Purpose of the Study:
- To compare airborne particle generation during the draping of surgical microscopes and exoscopes.
- To investigate the influence of device type on transient airborne particulate dynamics.
- To assess the contribution of draping procedures to operating room contamination.
Main Methods:
- Prospective observational study in a laminar airflow operating room.
- Comparison of surgical microscope (Pentero) and exoscope (Orbeye) draping during 10 spinal surgeries.
- Airborne particle counts (0.5 μm and 1.0 μm) measured at 5-second intervals for 1 minute post-drape initiation.
Main Results:
- No significant difference in cumulative particle exposure between exoscopes and microscopes.
- Exoscope draping showed a trend towards lower 0.5 μm particle exposure (AUC).
- A significant time-by-device interaction for 0.5 μm particles indicated lower initial counts with exoscopes.
Conclusions:
- Transient airborne particle behavior during draping is device-dependent.
- Device configuration and draping mechanics influence particle generation.
- Controlled draping and awareness of device-specific airflow can mitigate contamination risk.
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