Sterile Intra-operative Photography by Using a Digital Camera Encased in a Waterproof Case-the Feasibility Test in Clean Surgical Wound

Abstract

Background: No one except the surgeon himself can get a satisfactory intra-operation photograph. However, taking intra-operation photographs by surgeon himself always need to change gloves for preventing contamination. Sometimes, the camera needs to be positioned crossover the sterile territory and runs the risk of contamination in order to get a good picture. Herein, we introduce a simple and safe method for surgeons to get good intra-operative photographs without changing gloves or running the risk of contamination. Aim and Objectives: We would like to prove that taking intra-operative photos by using digital camera encased in the waterproof case will not cause wound infection. Material and Methods: From April of 2008 to November of 2008, fifteen patients who received surgery at Chang-Gung Memorial Hospital, two male and thirteen female patients, were enrolled in this study prospectively. A Samsung Digimax i5 digital camera and a Samsung SPH-A3 Waterproof Case (specific for the Samsung Digimax i5 digital camera) are used in this design. The digital camera, encased in the sterilized waterproof case, was used to take intra-operative photographs for each patient. Before operation, the waterproof case was sterilized for 75 minutes in STERRAD 100 Sterilizer, which employs hydrogen peroxide gas plasma sterilization. After finishing the sterilization, the digital camera was encased in the waterproof case by the standard procedure for sterilized material in surgical operation. Before creating a wound on a patient, aerobic and anaerobic swab culture was done to the whole device surface immediately after finishing setting up the device. Wound culture was also done during operation. After finishing the surgery, swab culture was done to the whole device again. Each wound's photos were taken by a single surgeon with the device. The total operation time and length of hospitalization were recorded. All the patients were followed up for one month to one year. Results: Two male and thirteen female were included in this study and the mean age of patients enrolled was 60.3±12.6 years old. The mean operation time was 1.8±0.9 hrs and the mean length of hospitalization was 2.7+2.3 days. All the wound culture of the enrolled patients showed negative results. All the surface culture of the water proof case also showed negative findings. Before discharging, there was no infection sign on each wound. The patients return to clinic for removing stitches and wounds following up and there was no additional infection occurred in patients included in this study during three months to one year follow up. Conclusions: In our study, we proved that using digital camera within waterproof case can meet the requirement of surgical sterilization and will not cause additional infection in enrolled patients. Operators can capture intra-operative pictures or make intra-operative video clips without changing gloves and strict sterilization. The case can be repeatedly sterilized at low temperature without damaging the plastic and rubber seal. Short interval of sterilization time makes it possible for surgeons to quickly reuse the case for other scheduled operations without affecting photo qualities. Therefore, we highly recommend this design in surgical photography.