title: [Evaluation of radiation exposure of personnel in an orthopaedic and trauma operation theatre using the new real-time dosimetry system "dose aware"].
abstract: OBJECTIVE
  There is a positive correlation between operation time and staff exposure to radiation during intraoperative use of C-arm fluoroscopy. Due to harmful effects of exposure to long-term low-dose radiation for both the patient and the operating team it should be kept to a minimum. AIM of this study was to evaluate a novel dosimeter system called Dose Aware® (DA) enabling radiation exposure feedback of the personal in an orthopaedic and trauma operation theatre in real-time.
  
  
  METHODS
  Within a prospective study over a period of four month, DA was applied by the operation team during 104 orthopaedic and trauma operations in which the C-arm fluoroscope was used in 2D-mode. During ten operation techniques, radiation exposure of the surgeon, the first assistant, the theatre nurse and the anaesthesiologist was evaluated.
  
  
  RESULTS
  Seventy-three operations were analysed. The surgeon achieved the highest radiation exposure during dorsolumbar spinal osteosynthesis, kyphoplasty and screw fixation of sacral fractures. The first assistant received a higher radiation exposure compared to the surgeon during plate osteosynthesis of distal radius fractures (157 %), intramedullary nailing of pertrochanteric fractures (143 %) and dorsolumbar spinal osteosynthesis (240 %). During external fixation of ankle fractures (68 %) and screw fixation of sacral fractures (66 %) radiation exposure of the theatre nurse exceeded 50 % of the surgeon's radiation exposure. During plate osteosynthesis of distal radius fractures (157 %) and intramedullary splinting of clavicular fractures (115 %), the anaesthesiologist received a higher radiation exposure than the surgeon.
  
  
  CONCLUSIONS
  The novel dosimeter system DA provides real-time radiation exposure feedback of the personnel in an orthopaedic and trauma operation theatre for the first time. Data of this study demonstrate that radiation exposure of the personnel depends on the operation type. The first assistant, the theatre nurse and the anaesthesiologist might be exposed to higher radiation doses than the surgeon. DA might help to increase awareness concerning irradiation in an orthopaedic and trauma operation theatre and might enhance staff compliance in using radiation protection techniques.
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: M C
authors.initials: MC
authors.lastname: Müller
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: A
authors.initials: A
authors.lastname: Strauss
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: R
authors.initials: R
authors.lastname: Pflugmacher
authors.affiliation: Klinik für Radiologie, Universitätsklinikum Bonn.
authors.forename: C P
authors.initials: CP
authors.lastname: Nähle
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: P H
authors.initials: PH
authors.lastname: Pennekamp
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: C
authors.initials: C
authors.lastname: Burger
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: D C
authors.initials: DC
authors.lastname: Wirtz
mesh_terms: D003199:Computer Systems; D005471:Fluoroscopy / Q000009:adverse effects; D006801:Humans; D008297:Male; D016273:Occupational Exposure; D009873:Operating Rooms; D061646:Operative Time; D019637:Orthopedic Procedures; D010348:Patient Care Team; D011446:Prospective Studies; D011832:Radiation Injuries / Q000517:prevention & control; D011835:Radiation Protection; D011874:Radiometry / Q000295:instrumentation*; D013223:Statistics as Topic; D014947:Wounds and Injuries / Q000601:surgery*