Preoperative Sterilization Preparation of the Shoulder: A Comparative Study Evaluating Gauze Sponge and Commercially Available Applicator Prep Stick | ||
| The Archives of Bone and Joint Surgery | ||
| مقاله 7، دوره 6، شماره 1، فروردین 2018، صفحه 34-38 اصل مقاله (600.79 K) | ||
| نوع مقاله: RESEARCH PAPER | ||
| شناسه دیجیتال (DOI): 10.22038/abjs.2017.21767.1570 | ||
| نویسندگان | ||
| Usman Syed1؛ Adam J. Seidl2؛ Ryan A. Hoffman3؛ Justin Bianchini4؛ Pedro Beredjiklian5؛ Joseph A. Abboud* 1 | ||
| 1Shoulder and Elbow Division, The Rothman Institute, Philadelphia, PA, USA | ||
| 2Department of Orthopedics, University of Colorado, USA | ||
| 3Medical Student, Drexel University College of Medicine, Philadelphia, PA | ||
| 4Department of Biomedical Engineering, Drexel University, Philadelphia, PA, USA | ||
| 5Division of Hand Surgery Rothman Institute, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA | ||
| چکیده | ||
| Background: Surgical site infection (SSI) remains a concern in shoulder surgery, especially during arthroplasty. While many studies have explored the characteristics and efficacy of different sterilizing solutions, no study has evaluated the method of application. The purpose of this study was to compare two popular pre-surgical preparatory applications (two 4 x 4 cm gauze sponges and applicator stick) in their ability to cover the skin of the shoulder. Methods: Two orthopedic surgeons simulated the standard pre-surgical skin preparation on 22 shoulders of volunteer subjects. Each surgeon alternated between an applicator stick and two sterile 4x4 cm gauze sponges. Skin preparation was performed with a commercially available solution that can be illuminated under UV-A light. Advanced imageanalysis software was utilized to determine un-prepped areas. A two-tailed paired t-test was performed to compare percentage of un-prepped skin. Results: The applicator stick method resulted in a significantly higher percentage of un-prepped skin (27.25%, Range 10-49.3) than the gauze sponge method (15.37%, Range 5-32.8, P=0.002). Based on image evaluation, most unprepped areas were present around the axilla. Conclusion: Based on our findings, the use of simple gauze sponges for pre-surgical preparatory application of sterilization solution may result in a lower percent of un-prepped skin than commercially available applicator stick. Orthopaedic surgeons and operating room staff should be careful during the pre-surgical sterile preparation of the shoulder, especially the region around the axilla, in order to reduce the potential risk of surgical site infection. | ||
| کلیدواژهها | ||
| Applicator stick؛ Gauze sponge؛ Infection؛ shoulder؛ Sterile preparation؛ Surgical site infection | ||
| مراجع | ||
|
1. Boekel P, Blackshaw R, Van Bavel D, Riazi A, Hau R. Sterile stockinette in orthopaedic surgery: a possible pathway for infection. ANZ J Surg. 2012; 82(11):838-43. 2. Lee MJ, Pottinger PS, Butler-Wu S, Bumgarner RE, Russ SM, Matsen FA 3rd. Propionibacterium persists in the skin despite standard surgical preparation. J Bone Joint Surg Am. 2014; 96(17):1447-50. 3. Savage JW, Weatherford BM, Sugrue PA, Nolden MT, Liu JC, Song JK, et al. Efficacy of surgical preparation solutions in lumbar spine surgery. J Bone Joint Surg Am. 2012; 94(6):490-4. 4. Sperling JW, Kozak TK, Hanssen AD, Cofield RH. Infection after shoulder arthroplasty. Clin Orthop. 2001; 382(1):206-16. 5. Coste JS, Reig S, Trojani C, Berg M, Walch G, Boileau P. The management of infection in arthroplasty of the shoulder. J Bone Joint Surg Br. 2004; 86(1):65-9. 6. Dodson CC, Craig EV, Cordasco FA, Dines DM, Dines JS, Dicarlo E, et al. Propionibacterium acnes infection after shoulder arthroplasty: a diagnostic challenge. J Shoulder Elbow Surg. 2010; 19(2):303-7. 7. Padegimas EM, Maltenfort M, Ramsey ML, Williams GR, Parvizi J, Namdari S. Periprosthetic shoulder infection in the United States: incidence and economic burden. J Shoulder Elbow Surg. 2015; 24(5):741-6. 8. Singh JA, Sperling JW, Schleck C, Harmsen WS, Cofield RH. Periprosthetic infections after total shoulder arthroplasty: a 33-year perspective. J Shoulder Elbow Surg. 2012; 21(11):1534-41. 9. Verhelst L, Stuyck J, Bellemans J, Debeer P. Resection arthroplasty of the shoulder as a salvage procedure for deep shoulder infection: does the use of a cement spacer improve outcome? J Shoulder Elbow Surg. 2011; 20(8):1224-33. 10. Wirth MA, Rockwood Jr CA. Complications of shoulder arthroplasty. Clin Orthop Relat Res. 1994; 307(1):47-69. 11. Ambrose CG, Clyburn TA, Mika J, Gogola GR, Kaplan HB, Wanger A, et al. Evaluation of antibioticimpregnated microspheres for the prevention of implant-associated orthopaedic infections. J Bone Joint Surg Am. 2014; 96(2):128-34. 12. Glen L, Scammell B, Ashraf W, Bayston R. How sterile is patient’s skin after preparation with alcoholic povidone iodine? Orthop Proc. 2012; 94(Suppl 18):34. 13. Ricciardi BF, Bostrom MP, Lidgren L, Ranstam J, Merollini KM, W-Dahl A. Prevention of surgical site infection in total joint arthroplasty: an international tertiary care center survey. HSS J. 2014; 10(1):45-51. 14. Phadnis J, Gordon D, Krishnan J, Bain GI. Frequent isolation of Propionibacterium acnes from the shoulder dermis despite skin preparation and prophylactic antibiotics. J Shoulder Elbow Surg. 2016; 25(2):304-10. 15. Saltzman MD, Nuber GW, Gryzlo SM, Marecek GS, Koh JL. Efficacy of surgical preparation solutions in shoulder surgery. J Bone Joint Surg Am. 2009; 91(8):1949-53. 16. Szpinda M, Daroszewski M, Szpinda A, Woźniak A, Wiśniewski M, Mila-Kierzenkowska C, et al. New quantitative patterns of the growing trachea in human fetuses. Med Sci Monit. 2012; 18(6):PH63-70. | ||
|
آمار تعداد مشاهده مقاله: 785 تعداد دریافت فایل اصل مقاله: 771 |
||