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Published on: January 16, 2019
Safety and Impact on Sustainability of Reduced Protective Equipment in Ultrasound-Guided Paracentesis: A
Dhiraj Sikaria1, Scott Tseng1, Bettina Siewert1
1Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Purpose:
To evaluate the impact of reducing protective equipment requirements on postprocedural infection rates in ultrasound (US)-guided paracenteses, comparing outcomes between full protective equipment protocol (sterile gloves, gown, surgical mask, and hat) and limited protective equipment protocol (sterile gloves only).
Materials And Methods:
A single-center retrospective study analyzed 1,177 consecutive US-guided paracenteses performed between June 1, 2021, and May 31, 2022. The study compared infection rates across two 6-month periods: before (619 procedures) and after (558 procedures) the December 1, 2021, policy change reducing protective equipment requirements. Primary outcome measures included postprocedural infection rates, specifically spontaneous bacterial peritonitis, soft tissue infection, or other intra-abdominal infections, evaluated at 7 and 14 days after the procedure. Analysis was conducted at both the individual paracentesis and patient levels.
Results:
No statistically significant differences were observed in postprocedural infection rates between the full and limited protective equipment groups. The 7-day infection rates were 1.1% and 0.9% (P = .41), and 14-day infection rates were 1.5% and 1.8% (P = .65) for full and limited protective equipment groups, respectively. Patient-level analysis showed similar results, with 14-day infection rates of 3.3% and 4.1% (P = .69). The median volume of fluid removed remained consistent between groups (3.2 L vs 3.0 L, P = .50).
Conclusions:
Sterile gloves alone provide adequate protection for US-guided paracentesis while reducing the use of protective equipment, enabling simplified protocols without compromising patient safety.
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