Summary Objective: To explore the impact of two types of placement of cleaning pads during surgery on the surgical operation of the operator. Method: Analyze the comparison results of two different placement positions for cleaning films in different surgical positions. ResultPlacing it on the sleeve of the surgical gown on the back of the surgeon’s forearm is an ideal choice. ConclusionAccording to the shape of the electric knife head and the application characteristics of the cleaning sheet, when the angle between the electric knife head and the cleaning sheet is less than 30 °, the removal of coking substances on the electric knife head is fast and effective. The cleaning piece is placed on the surgeon’s forearm, with dynamic coordination between the left and right hands, which can easily create a 30 ° angle with the electric knife head. It is convenient for the surgeon to use and is worth promoting.

[Keywords] Placement of high-frequency electric knife cleaning pads

High frequency electric knife is one of the indispensable and commonly used instruments in surgical operations. It uses high-frequency electric current to cut open tissues and wounds to stop bleeding. During use, the electric knife head is prone to adhering tissue and blood clotting and coking substances, which affects the cutting and hemostasis effect of the electric knife and the surgical process. At this point, doctors or hand washing nurses need to use the back of the surgical knife to scrape off the charred material, which not only delays the surgery but also easily damages the electric knife. The emergence of cleaning pads has solved this problem. Its surface is made of sandpaper, and there is adhesive on the back. When used, the cleaning pads are attached to a sterile sheet near the surgical field or to the sleeve of the surgeon’s forearm back surgical gown. When there is coking material on the electric knife, rub the knife back and forth on the cleaning sheet a few times. During clinical use, we found that the impact of two different placement positions of cleaning pads on the surgeon’s surgery is different. The following report is provided.

1 Materials and Methods

1.1 Material selection: Cleaning tablets produced by Pacific Medical Materials Co., Ltd., sterilized with ethylene oxide, valid for three years, with a specification of 5.0 cm × 5.0 cm.

1.2 Investigation methodsDivide the surgery using cleaning pads into two groups. In one group, place the cleaning pads on sterile sheets around the incision, and randomly select 160 cases; A set is placed on the sleeve of the surgical gown on the back of the left forearm of the surgeon. If the doctor holds a surgical knife in his left hand, a cleaning piece is placed on the sleeve of the surgical gown on the opposite side. 175 cases are randomly selected. After the surgery, please ask the doctor to fill out a survey form and conduct statistical analysis on the survey results.

2 Results

The comparison of satisfaction survey results between the two placement positions of intraoperative cleaning tablets by doctors is shown in Table 1.

3 Discussion

3.1 Comparison of placement positions of cleaning pads in different surgical positions Table 1 Comparison of doctor satisfaction survey on placement positions of cleaning pads

3.1.1 Horizontal positionWhen in a supine position, the cleaning sheet is placed flat on the sterile sheet. The surgeon is standing on both sides of the patient’s body and cannot place the cleaning sheet on the side of the patient’s body. In order to scrape off the coking material on the electric knife head, the surgeon will hold the electric knife and find the appropriate angle with the cleaning sheet. As the cleaning sheet is flat and not moving, it is not easy to form an angle of less than 30 ° due to the influence of the patient’s body and the sterile sheet, and the hand rubs against the sterile sheet, It is very laborious to use. If the cleaning film is placed on the back of the surgeon’s forearm, it is easy to form an angle of less than 30 ° by rotating the left forearm and cooperating with the electric knife on the right hand. When using it, only two front and back strokes are needed to scrape off the coking material.

3.1.2 Side lying positionThe surgical incision in the lateral position is mostly on the side of the patient’s body, and the cleaning film is placed on the side of the patient’s body. During use, it is not affected by the patient’s body and sterile blade, making it more convenient than the supine position. However, the patient does not move, only the right hand holding the electric knife is moving, lacking coordination. It is better to place the cleaning film on the back of the operator’s forearm due to the influence of the sterile blade. The cleaning film and electric knife head are in dynamic coordination, and the operator’s eyes do not need to leave the surgical field, The effect of removing coking substances is good.

3.1.3 Prone position (similar to supine position)When performing surgery on the patient’s back, waist, buttocks, and legs, the use of the cleaning film is affected by body position, physiological curvature, and the influence of the contralateral limb. The flat surface of the electric knife head is not easily in full contact with the cleaning film. It is better to place the cleaning film on the left forearm when using it. The electric knife head and the cleaning film are in face-to-face contact, which is accurate, ideal, convenient, labor-saving, and fast in removing coking substances.

3.1.4 Stone cutting positionThe stone cutting position is commonly seen in gynecological, proctology, and general surgery. The surgeon sits on a small stool, between the patient’s legs. If the cleaning sheet is placed on the sterile sheet on the inner side of the patient’s left and right thighs, the surgeon must raise the electric knife hand to scrape off the charred material during use. After the surgery, the doctor feels that the arm is very tired. If the cleaning piece is placed in another position, due to the special nature of the stone cutting position, the surgeon may not have a fulcrum when using it, which feels like touching a cloth curtain and is extremely inconvenient to use. If the cleaning film is placed on the back of the left forearm, this phenomenon will be eliminated, and the patient will feel satisfied after the surgery.

3.2 Changes in the position of the surgeonDue to the needs of surgery, in order to facilitate operation, the operator needs to switch positions with their assistant. Generally, the electric knife is used by the operator. As the operator also needs to change the position of the cleaning film, frequent changes in position will cause the adhesive on the back of the cleaning film to lose its function, and the cleaning film will fall off. Re applying a new film will increase the patient’s financial burden. Due to the fact that our hospital does not charge for cleaning tablets, adding an extra one will increase the cost for the department.

3.3 Impact of using cleaning tablets under local anesthesia on patientsLocal anesthesia is a method of injecting anesthesia to block the spinal nerves, nerve plexus or nerve trunk, as well as finer peripheral nerve endings. After local anesthesia, the patient’s consciousness is clear and feels normal. If the cleaning pad is applied to the patient’s chest, especially to the breast area of female patients (commonly seen in head, face, neck, upper arm surgery), it should be rubbed back and forth on the patient’s chest during surgery. Patients may feel disrespected, insulted, and harassed. When performing surgery on the spine, buttocks, or thighs in a prone position, patients may also feel uncomfortable when placed on their buttocks or other sensitive areas.

4 Summary

(1) The cleaning film is suitable for all surgical positions when placed on the operator’s forearm, without the need for the operator to search for optimal angles on sterile dressings. The operator’s left and right hands dynamically cooperate with each other during use, and the flat surface of the electric knife head is easy to contact with the cleaning film. It only requires two front and back movements to remove coking materials, saving time, improving surgical efficiency, reducing intraoperative bleeding, shortening surgical time, and saving surgical costs for patients. (2) The cleaning film is placed on the surgeon’s forearm to avoid changing the position of the cleaning film due to the surgeon’s position change. This reduces the viscosity of the cleaning film and makes it easy to fall off, increasing operating room consumption. (3) The cleaning tablet is placed on the surgeon’s forearm, and during use, the patient will not feel uncomfortable, disrespected, insulted, or harassed due to local anesthesia. (4) Based on feedback from doctors, it is believed that applying cleaning pads to the forearm of the surgeon is more convenient, flexible, and quick to use, which shortens the surgical time, prevents coking materials from falling into the surgical field, reduces the workload of hand washing nurses, ensures the continuity of surgery, and is worth promoting and applying.

[Reference]

1. Wang Guimin, Shen Yongxia, Zhu Wei. Design and application of high-frequency electric knife cleaning pads. Shanxi Journal of Nursing, 1999, 8 (4): 143

2. Xu Qiming, Li Wenshuo. Clinical Anesthesiology. Beijing: People’s Health Publishing House, 2002, 7