RESUMO
BACKGROUND: Surgical site infection is a well-documented complication of surgery. While contact with fomites represents a recognised source of contamination, electrostatic charge can cause contamination without surface contact as shown in previous studies evaluating operating room equipment. In cases requiring fluoroscopy, an intraoperative X-ray method, it is common for a surgeon to point to the associated monitor, particularly when teaching. This close proximity without direct contact poses a theoretical risk of contamination due to potential electrostatic forces. AIM/OBJECTIVE: To assess whether a gloved finger could be contaminated by a fluoroscopy monitor without direct contact. METHODS: Using a laser-guided level, a sterile, gloved finger was traversed side-to-side, top-to-bottom, across a fluoroscopy monitor used during surgery at distances of 1 cm, 2 cm, 4 cm and 8 cm. Two negative controls and a positive control were collected for comparison. Specimens were inoculated onto agar plates and incubated for 48 h at 37 °C. Following incubation, samples were analysed for growth and the number of colonies was recorded. This was repeated during 10 randomly selected operative cases using fluoroscopy for a total of 70 samples. RESULTS: No bacterial growth was identified as a result of inoculation on any of the 70 experimental or control specimens. DISCUSSION: We conclude that the practice of pointing to a fluoroscopy monitor for educational or other purposes is unlikely to increase the risk of glove contamination.
RESUMO
Achilles tendon pathology is one of the more common conditions encountered by the foot and ankle surgeon. While it most frequently affects the athletic population, it can also lead to significant morbidity in the older and sedentary patient. The etiology of Achilles tendon dysfunction is multifactorial and has been found to be associated with overuse injury, training error, malalignment of the lower extremity, inflammatory disorders, and intrinsic disease or degeneration. Achilles tendon disorders have been classified temporally as acute and chronic, with the later subdivided into insertional and non-insertional (intrinsic) involvement. Histopathology has contributed a great deal to the understanding of disease process. Classification systems have been developed in an attempt to determine methods of treatment and prognosis. This article reviews the clinical spectrum of disease and presents contemporary treatment options.
