[Factors associated with the quality of sterilization of surgical drapes at the National Hospital University Hubert Koutoukou Maga of Cotonou]. / Facteurs associés à la qualité de la stérilisation du linge opératoire au Centre National Hospitalier Universitaire Hubert Koutoukou MAGA de Cotonou.

INTRODUCTION: The sterilization of surgical drapes plays an important role in preventing infections associated with treatments. At the CNHU-HKM, sterilization procedure for drapes encounters problems. The purpose of this study was to examine the factors associated with the quality of sterilization of surgical drapes at the CNHU-HKM. METHODS: We conducted a cross-sectional, descriptive and analytical study focusing on 20 sterile surgical drapes, 41 agents were involved in the management of drapes and 55 members of the surgical team. The probabilistic method was used for sterile surgical drapes, the non-probabilistic method for the others. Pearson's Chi-square Test and logistic regression were used to find the association, with a significant threshold and a p<0.05. RESULTS: Eighty six point forty six percent of subjects were males with an average age of 42 years. The quality of the process of sterilization of the operative drapes was not good in the two departments responsible for processing the drapes. Bacteriological analysis showed that, out of 20 sterile surgical drapes, 9 had Acinetobacter spp. a multidrug-resistant germ causing nosocomial infections. Multivariate analysis showed that professional experience (p=0.015) and quality control of the procedure (p=0.034) were statistically associated with the quality of sterilization. CONCLUSION: The presence of Acinetobacter spp. on the sterilized drapes demonstrates that sterilization of drapes at the CNHU-HKM is of poor quality. Measures strengthening the skills of providers are necessary to improve the quality of sterilization procedures.

Flammability of surgical drapes and materials in varying concentrations of oxygen.

BACKGROUND: Over 600 operating room fires occur annually although many cases go unreported. Over 81% of operating room fires involve surgical drapes, yet limited data exist on the differing degrees of flammability of drapes and other surgical fuel sources in varying oxygen concentrations. The purpose of this study is to assess the flammability characteristics of fuels in the operating room under varying oxygen concentrations. METHODS: Five fuel sources were analyzed in three levels of oxygen: 21%, 50%, and 100%. Three test samples of each material were burned in a manner similar to that established by the Consumer Product Safety Commission. Time to sample ignition and time to complete burn were measured with video analysis. RESULTS: The median [minimum, maximum] ignition time in 21% oxygen was 0.9 s [0.3, 1.9], in 50% oxygen 0.4 s [0.1, 1.2], and in 100% oxygen 0.2 s [0.0, 0.4]. The median burn time in 21% oxygen was 20.4 s [7.8, 33.5], in 50% oxygen 3.1 s [1.4, 8.1], and in 100% oxygen 1.7 s [0.6, 2.7]. Time to ignite and total burn times decreased as oxygen concentration increased (P < 0.001). Flammability characteristics differed by material and oxygen concentration. Utility drapes and surgical gowns did not support combustion in room air, whereas other materials quickly ignited. Flash fires were detected on woven cotton materials in oxygen-enriched environments. CONCLUSIONS: Operating room personnel should be aware that common materials in the operating room support rapid combustion in oxygen-enriched environments. The risk of ignition and speed of fire propagation increase as oxygen exposure increases. Advances in material science may reduce perioperative fire risk.