目的:最近的研究表明,关节镜检查期间手套病变的发生率远低于初次和翻修关节成形术期间。然而,打结后的手套损坏率尚未系统地记录。因此,这项研究的目的是确定手术打结对手套完整性的影响。假设打结会增加手套损坏的速度,尤其是在关节镜手术中,这可能与肩袖撕裂的治疗特别相关。
方法:根据EN455,通过紧水试验研究了在缝合前立即更换且仅在打结期间佩戴的手套的完整性。来自40个全髋关节置换术(THA)的234个手套,收集了42例全膝关节置换术(TKAs)和36例肩袖修复(RCR)。在45分钟的佩戴时间后,在模拟无菌手术条件下对3名外科医生进行了手套损伤的细菌穿通测试(BPTT)。
结果:打结造成的手套损伤发生在25%的THA中,36.6%的TKA和25%的RCR手术。在THA,拉手(PH)受影响达46.2%,和损伤的主要区域(15.4%)被检测到在中指的尖端;在TKAs中,PH被损坏了75%,在RCR中,PH受到66.7%的影响,大多数病变(每个20%)发生在食指和无名指的尖端。BPTT显示人葡萄球菌和蜡状芽孢杆菌。
结论:术中打结会损坏手套,这与关节镜手术特别相关。而打结只是关节成形术中手套损伤的部分原因,在没有打结的情况下,关节镜手术中手套的一般损伤率较低。手术打结过程必须被理解为对手套的可能的破坏性影响。因此,不建议使用单套手套,这在关节镜手术中尤为重要,双手套还不是标准的。
方法:IV.
OBJECTIVE: Recent studies have shown that the incidence of glove lesions during arthroscopy is much lower than that during primary and revision arthroplasty. However, the rate of glove damage after knot tying has not yet been systematically recorded. Therefore, the aim of the study was to determine the impact of surgical knot tying on glove integrity. It was hypothesized that knot tying increases the rate of glove damage, especially in arthroscopic surgery, which could be of special relevance in the treatment of rotator cuff tears.
METHODS: Gloves that were changed immediately before suturing and only worn during knot tying were investigated for their integrity by means of water tightening test according to EN455. A total of 234 gloves from 40 total hip arthroplasties (THAs), 42 total knee arthroplasties (TKAs) and 36 rotator cuff repairs (RCRs) were collected. A bacterial pass-through test (BPTT) on glove lesions was performed under simulated sterile surgical conditions for 3 surgeons after a wear duration of 45 min.
RESULTS: Glove damage by knot tying occurred in 25% of THA, 36.6% of TKA and 25% of RCR surgeries. In THA, the pulling hand (PH) was affected in 46.2%, and the main area of damage (15.4%) was detected on the tip of the middle finger; in TKAs the PH was damaged in 75%, and in RCRs the PH was affected in 66.7%, with most of the lesions (20% each) occurring on the tip of the index finger and the ring finger. The BPTT showed Staphylococcus hominis and Bacillus cereus.
CONCLUSIONS: Intraoperative knot tying causes damage to gloves, which is of special relevance for arthroscopic surgery. Whereas knot tying is only partly responsible for glove damage in arthroplasty, the general rate of glove damage in arthroscopic surgery is low without knot tying. The surgical knot tying process must be understood as a possible damaging impact on the glove. Therefore, single gloving is not recommended, which is especially important in arthroscopic surgery, where double gloving is not yet standard.
METHODS: IV.