Guidelines for clothing in the operating theatre, 2021

Hafiani, El-Mahdi; Cassier, Pierre; Aho, Serge; Albaladéjo, Pierre; Beloeil, Hélène; Boudot, Evelyne; Carenco, Philippe; Lallemant, Florence; Leroy, Marie Gabrielle; Muret, Jane; Tamames, Corinne; Garnier, Marc

doi:10.1016/j.accpm.2022.101084

Cited by 18 publications

(4 citation statements)

References 21 publications

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“…Another explanation could be related to use by the center of many reusable medical devices such as mouth guards and anesthesia trays, counter to the current trend for use of disposable devices in many hospitals and clinics. In addition, disposable garments for staff are not used at the center as they are known to emit three times more GHGs than those made from cloth 21 22 . Moreover, anesthesiologists do not routinely use infusion (tubing, stopcock, and crystalloid solution) at our center, but only in cases of clinical signs of hypovolemia.…”

Section: Discussionmentioning

confidence: 99%

The carbon footprint of ambulatory gastrointestinal endoscopy

Lacroute

Marcantoni²,

Petitot³

et al. 2023

Endoscopy

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Background and study aims Endoscopy is considered the third highest generator of waste within healthcare. This is of public importance as approximately 18 million endoscopy procedures are performed yearly in the United States and 2 million in France. However, a precise measure of the carbon footprint of gastrointestinal endoscopy (GIE) is lacking. Methods This retrospective study for 2021 was conducted in an ambulatory GIE center in France where 8’524 procedures were performed on 6’070 patients. The annual carbon footprint (CF) of GIE was calculated using “Bilan Carbone” of the French Environmental and Energy Management Agency. This multi-criteria method accounts for direct and indirect greenhouse gas (GHG) emissions from energy consumption (gas and electricity), medical gases, medical and non-medical equipment, consumables, freight, travel and waste. Results Greenhouse gas emissions in 2021 are estimated at 241 tonnes CO2 equivalents (CO2e) at the center, giving a carbon footprint for one GIE procedure at 28·4 kg CO2e. The main greenhouse gas emission, 45 % of total, is from travel by patients and professionals at the center. Other emission sources, in rank order, are medical and non-medical equipment (32%), energy consumption (12%), consumables (7%), waste (3%), freight (0·4%) and medical gases (0·005%). Conclusions This is the first multi-criteria analysis assessing carbon footprint of gastrointestinal endoscopy. It highlights that travel, medical equipment and energy are major sources of this footprint, waste being a minor contributor. This study provides an opportunity to raise awareness among gastroenterologists of the carbon footprint of GIE procedures.

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Section: Discussionmentioning

confidence: 99%

The carbon footprint of ambulatory gastrointestinal endoscopy

Lacroute

Marcantoni²,

Petitot³

et al. 2023

Endoscopy

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“…So far, many guidelines recommend changing scrubs upon exit and/or re-entry to the OR [23][24][25]. The National Association of Theater Nurses (NATN) guidance recommends that staff should change into outer clothes when leaving the theater area and put on a new set when returning [23].…”

Section: Discussionmentioning

confidence: 99%

“…", "If staff must exceptionally and for imperative reasons leave the operating theatre with their operating theatre attire, they must change their clothes on their return to the operating theatre to limit infectious risk for the patient. ", and "In the event of a brief departure (a few minutes) from the operating theatre, an alternative strategy can consist in covering the operating theatre attire with a closed gown if they stay outside" [25].…”

Section: Discussionmentioning

confidence: 99%

Bacterial Contamination in Total Joint Replacement: Should We Change into a New Set of Clean Scrub Suits Whenever Entering the Operating Room?

Tateiwa

Takahashi

Ishida

et al. 2023

Life

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Background: The aims of this study are as follows: (1) to investigate the level and probability of bacterial contamination on scrub suits over time for medical personnel working inside and/or outside the operating room (OR) area; (2) to discuss the protective role of cover gowns against bacterial contamination; and (3) to consider the necessity of changing into clean suits whenever entering the OR in terms of preventing periprosthetic joint infection (PJI) in total joint replacement (TJR). Methods: The bacterial colony count was examined on the chest area of the scrub suits worn during various daily clinical practices. The genus/species of the contaminants were identified by matrix-assisted laser deposition ionization-time of flight mass spectrometry (MALDI-TOF MS). Results: The scrub suits worn outside the OR area showed a greater level of bacterial contamination than those worn inside the OR area, although the colony counts tended to increase over time both in and out of the area. The probability of contamination involving coagulase-negative staphylococci (CNS) (known as the primary cause of PJI) did not increase significantly in the scrubs worn inside the OR area, but did increase significantly after a long-time departure from the OR area. Conclusions: Our results suggest that wearing scrub suits outside and/or the long duration of wearing the same suits can significantly increase the level and probability of any bacterial contamination (including CNS) on scrub suits. We also found that wearing a cover gown over scrub suits outside the OR area may have only a limited protective role against bacterial contamination.

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“…All blocks were guided by ultrasound, using a high-frequency linear probe. Strict asepsis was required prior to initiation of the block, with sterile gloves, a sterile probe cover, a surgical mask and a head covering [ 11 ]. The skin was prepared with an alcohol-based chlorhexidine gluconate solution.…”

Section: Methodsmentioning

confidence: 99%

Serratus anterior plane block alone, paravertebral block alone and their combination in video-assisted thoracoscopic surgery: the THORACOSOPIC double-blind, randomized trial

Leviel,

Fourdrain,

Delatre

et al. 2024

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES Serratus anterior plane block (SAPB) and paravertebral block (PVB) are well known to reduce pain levels after video-assisted thoracic surgery (VATS). However, the relative efficacies of each block and a combination of the two have not been fully characterized. The objective of the present study was to assess the efficacy of PVB alone, SAPB alone, and the combination of PVB and SAPB with regard to the occurrence and intensity of pain after VATS. METHODS We conducted the THORACOSOPIC single-centre, double-blind, randomized trial in adult patients due to undergo elective VATS lung resection. The participants were randomized to PVB only, SAPB only and PVB+SAPB groups. The primary end-point was pain on coughing on admission to the postanaesthesia care unit (PACU). The secondary end-points were postoperative pain at rest and on coughing at other time points and the cumulative opioid consumption. Pain was scored on a visual analogue scale (VAS). RESULTS 156 patients (52 in each group) were included. On admission to the PACU, the three groups did not differ significantly with regard to the pain on coughing: the VAS score was 3 [0; 6], 4 [0; 8] and 2 [0; 6] in the PVB, SAPB and PVB+SAPB groups, respectively (P = 0.204). During postoperative care, the overall pain score was significantly lower in the SABP+PVP group at rest and on cough. CONCLUSIONS the combination of SABP+PVB could be beneficial for pain management in VATS in comparison to SABP or PVB alone.

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Guidelines for clothing in the operating theatre, 2021

Cited by 18 publications

References 21 publications

The carbon footprint of ambulatory gastrointestinal endoscopy

The carbon footprint of ambulatory gastrointestinal endoscopy

Bacterial Contamination in Total Joint Replacement: Should We Change into a New Set of Clean Scrub Suits Whenever Entering the Operating Room?

Serratus anterior plane block alone, paravertebral block alone and their combination in video-assisted thoracoscopic surgery: the THORACOSOPIC double-blind, randomized trial

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