William C. Beck

Gown-Glove Interface: A Possible Solution to the Danger Zone

The gown-glove interface is the weakest point in the present barrier system of gown and glove protection for the surgeon and other healthcare professionals who come into direct contact with body liquids. Try it yourself: put on a fluid-resistant gown and surgical gloves. See that the glove cuff is well proximal to the stockinette. Hold your wrist and forearm for a moment under running water. Wait a minute to see if your forearm is wet. A wet forearm during surgery would be a blooded one. We propose a gown redesign that creates a dart at the terminal forearm, sealed by a liquid-proof method, and then similarly sealing the proximal end of the glove to the sleeve.

Justified faith in surgical drapes: A new and safe material for draping

Abstract Conventional linen draping has little to recommend it, other than it gives a semblance of asepsis. A plastic drape material would make an ideal bacteriologic barrier; but is heat producing and is, therefore, not suitable in its present form. A prepared paper drape suitably treated to make it waterproof appears to be ideal as a bacterial barrier and is convenient. Collateral advantages of lesser importance are that it can be used in a single layer, is disposable and simple to store.

Choosing surgical illumination

(1) Lighting systems for the surgical task are combinations of ambient room lighting to complement the operating task light. The two must match to produce a good effect. (2) Only a few surgical task lights are available, and their characteristics and relative merits should be studied. (3) Ideally the surgeon should test the task light to judge its suitability for his taste.

The open door in the operating room.

Over the last few years there has been a growing interest in the operating room air as the medium of transmission of microorganisms that may cause surgical infections. Various manipulations of ventilating systems have been designed to provide predominantly unidirectional (laminar) airflow that is supposed to limit the settling of infective particles onto susceptible areas. Airflow diagrams are frequently displayed to illustrate their value. Most of these diagrams and, in fact, most of these studies show a boxlike room structure without doors. In a previous publication [I] we suggested that swinging doors disturb such airflow patterns by their bellows effect and can cause disturbing turbulences and admixture of “clean” (filtered) and unclean atmospheres. On the other hand Fox [2] has studied the subject of doors in his laminar flow model and has found them to be practically without effect. He suggested that in his room “the doors serve merely to control traffic and add nothing to the integrity of clean air.” The results of Fox’s study confirm the findings of Wolf, Harris, and Hall [3] that conventional rooms under positive pressure have exchange airflows around an open doorway. Specifically, they found a continuous thermally induced flow of cool air into a warm zone through the lower portion of a portal, and a corresponding flow from warm to cool air through the upper half of the same doorway.

Cystic hygroma of the groin; a rare entity.

Abstract A case of a cystic hygroma of the groin in a child is reported. It is a lesion of great rarity. It is, however, clear that this condition does occur in the groin.

Thrombosis prophylaxis and the pill

In light of the increased risk to many women using oral contraceptives of contracting thromboembolic disease it is suggested that patients with mild venous disease and significant reasons for using oral contraceptives should wear compressive support stockings. Though this regimen is obviously not for serious disease conditions which would rule out oral contraceptive use anyway it appears to be a convenient and simple prophylaxis that should increase the velocity of blood flow by reducing the volume of the venous bed without discomfort to the patient.