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Hi again Emma
Not much more helpful, but apparently the Consensus Proceedings have been updated this year (thanks to Dr Tammy Wijesuriya for letting me know)
Question 7: Does the type of surgical drape (disposable vs. nondisposable) used affect the risk of subsequent SSIs/PJIs in patients undergoing orthopedic surgery? Recommendation: Unknown. The data from nonorthopedic procedures suggest that disposable drapes resist bacterial passage and reduce the risks of subsequent SSIs. Impermeable barriers should be used regardless of whether disposable or nondisposable drapes are used. Level of Evidence: Limited Delegate Vote: Agree: 90%, Disagree: 3%, Abstain: 7% (Super Majority, Strong Consensus) Rationale: Surgical drapes act as a barrier to prevent the contamination of the surgical field during a procedure. They are used to isolate the prepared surgical field from the nonsterile, nonsurgical area. Reusable drapes are made of a woven material and are laundered and sterilized between procedures. In contrast, disposable drapes are usually made of nonwoven material and are disposed of after each operation. Various physical properties of drapes and surgical conditions can affect the bacterial permeability of drapes. For example, it is known that there is increased bacterial passage when drapes are made wet by normal saline or blood [73,74]. Disposable drapes have been shown to decrease rates of bacterial passage, even when made wet by normal saline; however, this decreased bacterial transmission does not clearly indicate decreased risks of SSIs/PJIs [75,76]. We performed a systematic review using PUBMED, Medline, Web of Science, Embase, Google Scholar, and the Cochrane Library of studies in English. We included journal articles, communications, and conference proceedings. Unfortunately, there is a paucity of studies relating specifically to orthopedic surgery on this topic. Randomized controlled trials in cardiac surgery and general surgery demonstrated no statistically significant differences in infection rates between the 2 types of drapes [77,78]. However, a different prospective randomized study of 102 reconstructive breast surgeries demonstrated a statistically significant lower rate of infection 30 days after surgery in the disposable drape cohort (0 vs. 12%) [79]. The current literature on this topic is inconclusive, and there are no studies involving orthopedic or spine surgery patients; future research efforts should be focused on this topic.
Cheers
Michael
Michael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W http://www.hsnph.org.au
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Hi Emma
A large Consensus forum by Orthopods in 2013 did not find type of drape an issue:
Question 29: What type of draping should be used (reusable or disposable)?
Delegate Vote: Agree: 90%, Disagree: 6%, Abstain: 4% (Strong Consensus)
Two RCTs were conducted comparing reusable and disposable drapes and gowns in coronary artery bypass graft and elective abdominal surgery, with SSI as their main outcome. None of these studies found differences between the two types of gowns and drapes.155, 156
The whole document can be found here: https://www.efort.org/wp-content/uploads/2013/10/philadelphia_consensus.pdf
Not sure it will be easy to convince them…
Cheers
Michael
Michael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W http://www.hsnph.org.au
[cid:image001.jpg@01D46C86.4CDB6090]
Dear Brains Trust,
In line with AS4187 we are trying to get linen out of our lives in Theatres!! I’m nearly there except for Orthopaedics…
It seems to be in joint theatres where they still like to use linen as a base cover to ensure asepsis before they place on the impervious disposable drapes.
My two questions are;
1. Has anyone found a disposable drape that potentially handles like linen?? – we have trialled various brands but the Orthopods have not found one they like – you may need to privately email me with this info re company names ect
2. Does anyone have any recent literature I can give to our Linen loving Surgeons re why not to use it for surgical procedures? !! I realise it’s seen as a foreign body – lint ect but need some firm evidence to assist with our hopeful conversion!
So appreciated & lovely to see you all at the Conference!!
Emma Trippe
Infection Control Consultant
[cid:image001.png@01D4889F.C7DDDA90]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au
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