title: Timing of C-arm drape contamination.
abstract: BACKGROUND
  Surgical site infection remains a concern in orthopedic surgery, and contamination of C-arm covers is a potentially modifiable risk factor.
  
  
  METHODS
  A single-cohort study was conducted using 30 consecutive patients undergoing operative fracture fixation. Cultures were obtained from the C-arm cover after initial draping and every 20 min thereafter. The total number of persons in the operating room (person-hours/h of study time) and the number of door openings were recorded. The C-arm position changes and the time to contamination were monitored.
  
  
  RESULTS
  The median time from the start of the operation to contamination was 20 min. There was a 17% contamination rate on initial draping, 50% at 20 min, 57% at 40 min, and 80% by 80 min. The C-arms in five cases were not contaminated during the surgery. Time to contamination correlated significantly with lateral position changes (correlation [r]=0.64; p=0.003) but was not related to C-arm position changes (r=0.22; p=0.34), number of door openings (r=0.20; p=0.39), or person-hours/h (r=0.04; p=0.85).
  
  
  CONCLUSIONS
  Contamination of the C-arm drape occurs often and early during surgery for orthopedic fractures. We recommend minimal contact with the C-arm to avoid contamination of the surgical field.
authors.affiliation: Department of Orthopedics, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Peters
authors.forename: Richard T
authors.initials: RT
authors.lastname: Laughlin
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Markert
authors.forename: David B
authors.initials: DB
authors.lastname: Nelles
authors.forename: Kyle L
authors.initials: KL
authors.lastname: Randall
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Prayson
mesh_terms: D015331:Cohort Studies; D003352:Corynebacterium / Q000302:isolation & purification; D004866:Equipment Contamination; D005592:Fracture Fixation / Q000009:adverse effects*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008837:Micrococcus / Q000302:isolation & purification; D009983:Orthopedic Equipment; D013210:Staphylococcus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000517:prevention & control; D013997:Time Factors