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수술에 사용되는 가운과 방포의 면재질과 부직포의재질의 비교 : 오염도, 수술부위감염, 침수성, 비용 측면
김종경,배직현,정재심,정은미,봉명례,이수정,박지수,이주연,신현진,김덕희,주홍순 병원간호사회 1998 임상간호연구 Vol.4 No.1
In these days, it is conscious that microorganism transfer through body fluid and blood pathogens. So we have concerned about the possibility of exposure of microorganism, such as HIV, during the period of surgery on a patient. Operating room personnel can be contaminated if microorganism strikes through the surgical gown. Surgical gown and drapes must protect patient and operator from exposure of microorganism. The sterilized linen gown can be prevented from infection. If it is wet with blood or body fluid, we look upon it as a contaminated one. Nosocomial infection is that a patient without any dormant symptom of infection at that time of being hospitalized shows its signs related to hospital. The protocol in relation with sterilization of surgical instruments, the use of aseptic technique and disinfection of operating room facilities, has continuously been presented so as to reduce surgical site infection. However, the studies about surgical gown have not been enoughly done. Surgical gown and drapes could be a carrier of blood pathogen which develops nosocomial infection. Periods of study is from June 20 to Oct 30 in 1997. Total case of procedure is 116 case. Each case is 38 case used of cotton, 39 case used of single use fabric in company C, 39 case used of single use fabric in company D. Cases are procedure of General surgery, Orthopedic surgery, Neuro surgery which use irrigation solution over 1000cc. Clean wound cases are Aneurysm clipping, Arthroscopic anterior and posterior cruciated ligament reconstruction, Arthroscopic meniscetomy. Clean-contaminated wound cases are Gastrectomy, Colectomy, Rectal operation. In the preoperation periods, measure the weight of gown(operator, 1st assistant) During operation periods, check the information of patient, existence of puncture of gloves and irrigation solution, number of operting room personnel. In the postoperation periods, measure the weight of used gown and culture. Sites of culture is 5 site of sleeve and waist of operator and 1st assistant, surgical site Method of culture is below. Attach the 5.5cm diameter cup with agar plate on each site for 30 seconds. Put it in warm cabinet for 48 hours, count the Number of microorganism and analyze the microorganism by bacillus-equality inspection in micro-biology laboratory, We used SAS program for data analysis that(2-test, ANOVA, Pearson's correlation RESULT 1. There was no significant difference of contamination statistically between two materials. But average number of microorganism in cotton was much more than in disposable spun-laced fiber. Average number of microorganism in wet site was much more than in dry site. It is significant statistically. 2. There was a difference of wet area between 2 materials. Linen was wet more inside & outside of gown & drape than single use spun-laced fiber. Change of weight in gown was much more in linen than disposable. 3. There was no symptom of surgical site infection in clean wound. But It happened 2 cases of surgical site infection out of 64 cases of clean-contaminated wound. 4. Cost of linen was lower than spun-laced fiber by 2-5 times. Actually, we got to know number of microorganism in wet site is more than dry site. Water immersion of linen is more than single use spun-laced fiber, so possibility of contamination is also much in linen. There were 2 surgical site infection in clean-contaminated wound of linen. Cost of linen was lower than single use, but we must check invisible cost, such as time saving in draping, cost arise from surgical site infection. Because gown and drapes are easy to wet with water or blood, we suggest the material for using surgical gown and drapes are waterproof cotton or single use spun-laced fiber.
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