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J Hand Microsurg 2022; 14(02): 153-159
DOI: 10.1055/s-0040-1714434
Original Article

Sterility of Miniature C-arm Fluoroscopy in Hand and Upper Extremity Surgery

James P. Hovis   *
1   Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Stephanie N. Moore-Lotridge   *
1   Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Ashton Mansour
1   Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Breanne H.Y. Gibson
2   Department of Pharmacology, Vanderbilt University, Robinson Research, Nashville, Tennessee, United States
,
Douglas R. Weikert
1   Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Mihir J. Desai
1   Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Sandra S. Gebhart
1   Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Jonathan G. Schoenecker
1   Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
2   Department of Pharmacology, Vanderbilt University, Robinson Research, Nashville, Tennessee, United States
3   Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
4   Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Donald H. Lee
1   Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
› Author Affiliations Funding S.N.M.L. was supported during her graduate work by a NIH-sponsored predoctoral training grant (T32GM007628); otherwise, no funding was received specifically for this project.
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Abstract

Previous studies have demonstrated that sterile equipment is frequently contaminated intraoperatively, yet the incidence of miniature c-arm (MCA) contamination in hand and upper extremity surgery is unclear. To examine this incidence, a prospective study of MCA sterility in hand and upper extremity cases was performed in a hospital main operating room (MOR) (n = 13) or an ambulatory surgery center operating room (AOR) (n = 16) at a single tertiary care center. Case length, MCA usage parameters, and sterility of the MCA through the case were examined. We found that MOR surgical times trended toward significance (p = 0.055) and that MOR MCAs had significantly more contamination prior to draping than AOR MCAs (p < 0.001). In MORs and AORs, 46.2 and 37.5% of MCAs respectively were contaminated intraoperatively. In MORs and AORs, 85.7 and 80% of noncontaminated cases, respectively, used the above hand- table technique, while 50 and 83.3% of contaminated MOR and AOR cases, respectively, used a below hand-table technique. Similar CPT codes were noted in both settings. Thus, a high-rate of MCA intraoperative contamination occurs in both settings. MCA placement below the hand-table may impact intraoperative contamination, even to distant MCA areas. Regular sterilization of equipment and awareness of these possible risk factors could lower bacterial burden.

Keywords

Miniature C-arm - infection - contamination - surgical contamination - hand - surgery

* Both the authors contributed equally to the study.


Supplementary Material



Publication History

Article published online:
26 July 2020

© 2020. Society of Indian Hand Surgery & Microsurgeons. All rights reserved.

Thieme Medical and Scientific Publishers Private Ltd.
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