Research Article
BibTex RIS Cite

Ortopedi ameliyathanesinde radyasyon

Year 2015, Volume: 49 Issue: 3, 297 - 301, 17.07.2015
https://doi.org/10.3944/AOTT.2015.14.0250

Abstract

Amaç: Çalışmamızda amaç ortopedi ameliyathanesinde ne kadar radyasyona maruz kalındığını belirlemek, tüpten uzaklaştıkça radyasyon dozunun azaldığını göstermek ve personeli korunma konusunda bilgilendirmektir.

Çalışma planı: 18.02.2014 ile 02.06.2014 tarihleri arasında floroskop kullanılan ortopedi ameliyathanesinde, iyonize radyasyon ölçümü yapıldı. 4 adet dozimetre ameliyat masası baş ve ayak uçlarında ve bu bölgelere 200 cm uzaklıkta bulunan, 60 cm yükseklikte dikey zemine yerleştirildi.

Bulgular: 104 gün sonunda, 1 nolu dozimetrede (masanın ayak kısmında) 90.5 mrem, 2 no dozimetrede (masanın baş kısmında) 68.17 mrem, 3 no dozimetrede (masanın ayak kısmından 200 cm uzakta) 7.5 mrem, 4 no dozimetrede (masanın başkısmının 200 cm uzağına) 5.17 mrem toplam değerleri bulduk. Radyasyon kaynağından uzaklaşarak saptanabilir değerlerde belirgin azalmalar olduğunu gözlemledik.

Çıkarımlar: Radyasyon kaynağından uzaklaştıkça dozimetrelerde saptanan radyasyon oranı düşmektedir. Ortopedik cerrahide floroskopi kullanımı sırasında kurşunlu zırhlı koruyucu önlük, boyunluk ve gözlük kullanımı yanı sıra tüpten uzak durulması da kişilerin maruz kalacağı radyasyonu azaltmaktadır.

 

DOI: 10.3944/AOTT.2015.14.0250

Bu özet, makalenin henüz redaksiyonu tamamlanmamış haline aittir ve bilgi verme amaçlıdır. Yayın aşamasında değişiklik gösterebilir.

References

  • Lee SY, Min E, Bae J, Chung CY, Lee KM, Kwon SS, et al. Types and arrangement of thyroid shields to reduce exposure of surgeons to ionizing radiation during intraop- erative use of C-arm fluoroscopy. Spine (Phila Pa 1976) 2013;38:2108–12.
  • Kesavachandran CN, Haamann F, Nienhaus A. Radiation exposure of eyes, thyroid gland and hands in orthopaedic staff: a systematic review. Eur J Med Res 2012;17:28.
  • Badman BL, Rill L, Butkovich B, Arreola M, Griend RA. Radiation exposure with use of the mini-C-arm for routine orthopaedic imaging procedures. J Bone Joint Surg Am. 2005;87:13–7.
  • Park MS, Lee KM, Lee B, Min E, Kim Y, Jeon S, et al. Comparison of operator radiation exposure between C- arm and O-arm fluoroscopy for orthopaedic surgery. Ra- diat Prot Dosimetry 2012;148:431–8.
  • Teitelbaum GP, Shaolian S, McDougall CG, Preul MC, Crawford NR, Sonntag VK. New percutaneously in- serted spinal fixation system. Spine (Phila Pa 1976) 2004;29:703–9.
  • Blakely EA. Biological effects of cosmic radiation: deter- ministic and stochastic. Health Phys 2000;79:495–506.
  • Arnstein PM, Richards AM, Putney R. The risk from ra- diation exposure during operative X-ray screening in hand surgery. J Hand Surg Br 1994;19:393–6.
  • Singer G. Occupational radiation exposure to the surgeon. J Am Acad Orthop Surg 2005;13:69–76.
  • Jablon S, Bailar JC 3rd. The contribution of ionizing ra- diation to cancer mortality in the United States. Prev Med 1980;9:219–26.
  • Tse V, Lising J, Khadra M, Chiam Q, Nugent R, Yeaman L, et al. Radiation exposure during fluoroscopy: should we be protecting our thyroids? Aust N Z J Surg 1999;69:847–8.
  • Mastrangelo G, Fedeli U, Fadda E, Giovanazzi A, Scoizzato L, Saia B. Increased cancer risk among surgeons in an ortho- paedic hospital. Occup Med (Lond) 2005;55:498–500.
  • Faure E. X-rays-induced secretion of cellular factor(s) that enhance(s) HIV-1 promoter transcription in various non- irradiated transfected cell lines. Cell Mol Biol (Noisy-le- grand) 1998;44:1275–92.
  • Prasarn ML, Martin E, Schreck M, Wright J, Westesson PL, Morgan T, et al. Analysis of radiation exposure to the orthopaedic trauma patient during their inpatient hospi- talisation. Injury 2012;43:757–61.
  • International Commission on Radiological Protection: ICRP Publication 60: 1990 Recommendations of the In- ternational Commission on Radiological Protection. Ann ICRP 1991;2:1–3.
  • Mehlman CT, DiPasquale TG. Radiation exposure to the orthopaedic surgical team during fluoroscopy: “how far away is far enough?”. J Orthop Trauma 1997;11:392–8.
  • Committee to Assess Health Risks from Exposure to Low Levels of Ionising Radiation; Nuclear and Radiation Stud- ies Board, Division on Earth and Life Studies, National Research Council of the National Academies. Health risks from exposure to low levels of ionising radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press; 2006.
  • Wrixon AD. New ICRP recommendations. J Radiol Prot 2008;28:161–8.
  • Barry TP. Radiation exposure to an orthopedic surgeon. Clin Orthop Relat Res 1984;182:160–4.
  • Giordano BD, Ryder S, Baumhauer JF, DiGiovanni BF. Exposure to direct and scatter radiation with use of mini- c-arm fluoroscopy. J Bone Joint Surg Am 2007;89:948–52.
  • Sinclair WK. Radiation protection recommendations on dose limits: the role of the NCRP and the ICRP and future developments. Int J Radiat Oncol Biol Phys 1995;31:387– 92.
  • Hall EJ, Brenner DJ. Cancer risks from diagnostic radiol- ogy. Br J Radiol 2008;81965:362–78.
  • Ismail S, Khan FA, Sultan N, Naqvi M. Radiation expo- sure of trainee anaesthetists. Anaesthesia 2006;61:9–14.
  • Agarwal A. Radiation Risk in Orthopedic Surgery: Ways to Protect Yourself and the Patient. Elsevier Inc. Oper Tech Sports Med 2011;19:220–3.
  • Miller ME, Davis ML, MacClean CR, Davis JG, Smith BL, Humphries JR. Radiation exposure and associated risks to operating-room personnel during use of fluoroscopic guid- ance for selected orthopaedic surgical procedures. J Bone Joint Surg Am 1983;65:1–4.
  • Khan F, Ul-Abadin Z, Rauf S, Javed A. Awareness and at- titudes amongst basic surgical trainees regarding radiation in orthopaedic trauma surgery. Biomed Imaging Interv J 2010;6:25.
  • Mariscalco MW, Yamashita T, Steinmetz MP, Krishnaney AA, Lieberman IH, Mroz TE. Radiation exposure to the surgeon during open lumbar microdiscectomy and mini- mally invasive microdiscectomy: a prospective, controlled trial. Spine (Phila Pa 1976) 2011;36:255–60.
  • Faulkner K, Harrison RM. Estimation of effective dose equivalent to staff in diagnostic radiology. Phys Med Biol 1988;33:83–91.
  • Theocharopoulos N, Perisinakis K, Damilakis J, Papa- dokostakis G, Hadjipavlou A, Gourtsoyiannis N. Oc- cupational exposure from common fluoroscopic projec- tions used in orthopaedic surgery. J Bone Joint Surg Am 2003;85–A:1698–703.
  • Rampersaud YR, Foley KT, Shen AC, Williams S, Solo- mito M. Radiation exposure to the spine surgeon during fluoroscopically assisted pedicle screw insertion. Spine (Phila Pa 1976) 2000;25:2637–45.
  • Lee K, Lee KM, Park MS, Lee B, Kwon DG, Chung CY. Measurements of surgeons’ exposure to ionizing radiation dose during intraoperative use of C-arm fluoroscopy. Spine (Phila Pa 1976) 2012;37:1240–4.
  • Murphy PH, Wu Y, Glaze SA. Attenuation properties of lead composite aprons. Radiology 1993;186:269–72.
  • Lyra M, Charalambatou P, Sotiropoulos M, Diamanto- poulos S. Radiation protection of staff in 111In radionu- clide therapy--is the lead apron shielding effective? Radiat Prot Dosimetry 2011;147:272–6.
  • Schueler BA, Balter S, Miller DL. Radiation protec- tion tools in interventional radiology. J Am Coll Radiol 2012;9:844-5.
  • Blattert TR, Fill UA, Kunz E, Panzer W, Weckbach A, Regulla DF. Skill dependence of radiation exposure for the orthopaedic surgeon during interlocking nailing of long- bone shaft fractures: a clinical study. Arch Orthop Trauma Surg 2004;124:659–64.
  • Tuohy CJ, Weikert DR, Watson JT, Lee DH. Hand and body radiation exposure with the use of mini C-arm fluo- roscopy. J Hand Surg Am 2011;36:632–8.
  • Madan S, Blakeway C. Radiation exposure to surgeon and patient in intramedullary nailing of the lower limb. Injury 2002;33:723–7.
  • Seibert JA. Digital radiography: image quality and radia- tion dose. Health Phys 2008;95:586–98.
  • Kahler DM. Navigated long-bone fracture reduction. J Bone Joint Surg Am 2009;91 Suppl 1:102–7.

Radiation in the orthopedic operating theatre

Year 2015, Volume: 49 Issue: 3, 297 - 301, 17.07.2015
https://doi.org/10.3944/AOTT.2015.14.0250

Abstract

Objective: The aim of the study was to determine the amount of radiation exposure in the orthopedic operating theater, to show that the radiation dose was decreased with distance from the tube, and to inform personnel about protective measures.
Methods: Ionised radiation was measured in the orthopedic operating theater where fluoroscopy was used between 18 February 2014 and 02 June 2014. Four dosimeters were placed at the head and foot of the operating table and at 200 cm from those areas at a height of 60 cm vertical to the floor.
Results: At the end of 104 days, the total values were determined as 90.5 mrem at the foot of the table, 68.17 mrem at the head of the table, 7.5 mrem at 200 cm from the foot of the table, and 5.17 mrem at 200 cm from the head of the table. A significant decrease was observed in the values determined at a distance from the radiation source.
Conclusion: The rate of radiation determined in the dosimeters decreased when distance from the radiation source increased. During the use of fluoroscopy in orthopedic surgery, the wearing of lead aprons, neck protectors, and glasses, in addition to maintaining a distance from the tube, will reduce the radiation exposure of individuals.

References

  • Lee SY, Min E, Bae J, Chung CY, Lee KM, Kwon SS, et al. Types and arrangement of thyroid shields to reduce exposure of surgeons to ionizing radiation during intraop- erative use of C-arm fluoroscopy. Spine (Phila Pa 1976) 2013;38:2108–12.
  • Kesavachandran CN, Haamann F, Nienhaus A. Radiation exposure of eyes, thyroid gland and hands in orthopaedic staff: a systematic review. Eur J Med Res 2012;17:28.
  • Badman BL, Rill L, Butkovich B, Arreola M, Griend RA. Radiation exposure with use of the mini-C-arm for routine orthopaedic imaging procedures. J Bone Joint Surg Am. 2005;87:13–7.
  • Park MS, Lee KM, Lee B, Min E, Kim Y, Jeon S, et al. Comparison of operator radiation exposure between C- arm and O-arm fluoroscopy for orthopaedic surgery. Ra- diat Prot Dosimetry 2012;148:431–8.
  • Teitelbaum GP, Shaolian S, McDougall CG, Preul MC, Crawford NR, Sonntag VK. New percutaneously in- serted spinal fixation system. Spine (Phila Pa 1976) 2004;29:703–9.
  • Blakely EA. Biological effects of cosmic radiation: deter- ministic and stochastic. Health Phys 2000;79:495–506.
  • Arnstein PM, Richards AM, Putney R. The risk from ra- diation exposure during operative X-ray screening in hand surgery. J Hand Surg Br 1994;19:393–6.
  • Singer G. Occupational radiation exposure to the surgeon. J Am Acad Orthop Surg 2005;13:69–76.
  • Jablon S, Bailar JC 3rd. The contribution of ionizing ra- diation to cancer mortality in the United States. Prev Med 1980;9:219–26.
  • Tse V, Lising J, Khadra M, Chiam Q, Nugent R, Yeaman L, et al. Radiation exposure during fluoroscopy: should we be protecting our thyroids? Aust N Z J Surg 1999;69:847–8.
  • Mastrangelo G, Fedeli U, Fadda E, Giovanazzi A, Scoizzato L, Saia B. Increased cancer risk among surgeons in an ortho- paedic hospital. Occup Med (Lond) 2005;55:498–500.
  • Faure E. X-rays-induced secretion of cellular factor(s) that enhance(s) HIV-1 promoter transcription in various non- irradiated transfected cell lines. Cell Mol Biol (Noisy-le- grand) 1998;44:1275–92.
  • Prasarn ML, Martin E, Schreck M, Wright J, Westesson PL, Morgan T, et al. Analysis of radiation exposure to the orthopaedic trauma patient during their inpatient hospi- talisation. Injury 2012;43:757–61.
  • International Commission on Radiological Protection: ICRP Publication 60: 1990 Recommendations of the In- ternational Commission on Radiological Protection. Ann ICRP 1991;2:1–3.
  • Mehlman CT, DiPasquale TG. Radiation exposure to the orthopaedic surgical team during fluoroscopy: “how far away is far enough?”. J Orthop Trauma 1997;11:392–8.
  • Committee to Assess Health Risks from Exposure to Low Levels of Ionising Radiation; Nuclear and Radiation Stud- ies Board, Division on Earth and Life Studies, National Research Council of the National Academies. Health risks from exposure to low levels of ionising radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press; 2006.
  • Wrixon AD. New ICRP recommendations. J Radiol Prot 2008;28:161–8.
  • Barry TP. Radiation exposure to an orthopedic surgeon. Clin Orthop Relat Res 1984;182:160–4.
  • Giordano BD, Ryder S, Baumhauer JF, DiGiovanni BF. Exposure to direct and scatter radiation with use of mini- c-arm fluoroscopy. J Bone Joint Surg Am 2007;89:948–52.
  • Sinclair WK. Radiation protection recommendations on dose limits: the role of the NCRP and the ICRP and future developments. Int J Radiat Oncol Biol Phys 1995;31:387– 92.
  • Hall EJ, Brenner DJ. Cancer risks from diagnostic radiol- ogy. Br J Radiol 2008;81965:362–78.
  • Ismail S, Khan FA, Sultan N, Naqvi M. Radiation expo- sure of trainee anaesthetists. Anaesthesia 2006;61:9–14.
  • Agarwal A. Radiation Risk in Orthopedic Surgery: Ways to Protect Yourself and the Patient. Elsevier Inc. Oper Tech Sports Med 2011;19:220–3.
  • Miller ME, Davis ML, MacClean CR, Davis JG, Smith BL, Humphries JR. Radiation exposure and associated risks to operating-room personnel during use of fluoroscopic guid- ance for selected orthopaedic surgical procedures. J Bone Joint Surg Am 1983;65:1–4.
  • Khan F, Ul-Abadin Z, Rauf S, Javed A. Awareness and at- titudes amongst basic surgical trainees regarding radiation in orthopaedic trauma surgery. Biomed Imaging Interv J 2010;6:25.
  • Mariscalco MW, Yamashita T, Steinmetz MP, Krishnaney AA, Lieberman IH, Mroz TE. Radiation exposure to the surgeon during open lumbar microdiscectomy and mini- mally invasive microdiscectomy: a prospective, controlled trial. Spine (Phila Pa 1976) 2011;36:255–60.
  • Faulkner K, Harrison RM. Estimation of effective dose equivalent to staff in diagnostic radiology. Phys Med Biol 1988;33:83–91.
  • Theocharopoulos N, Perisinakis K, Damilakis J, Papa- dokostakis G, Hadjipavlou A, Gourtsoyiannis N. Oc- cupational exposure from common fluoroscopic projec- tions used in orthopaedic surgery. J Bone Joint Surg Am 2003;85–A:1698–703.
  • Rampersaud YR, Foley KT, Shen AC, Williams S, Solo- mito M. Radiation exposure to the spine surgeon during fluoroscopically assisted pedicle screw insertion. Spine (Phila Pa 1976) 2000;25:2637–45.
  • Lee K, Lee KM, Park MS, Lee B, Kwon DG, Chung CY. Measurements of surgeons’ exposure to ionizing radiation dose during intraoperative use of C-arm fluoroscopy. Spine (Phila Pa 1976) 2012;37:1240–4.
  • Murphy PH, Wu Y, Glaze SA. Attenuation properties of lead composite aprons. Radiology 1993;186:269–72.
  • Lyra M, Charalambatou P, Sotiropoulos M, Diamanto- poulos S. Radiation protection of staff in 111In radionu- clide therapy--is the lead apron shielding effective? Radiat Prot Dosimetry 2011;147:272–6.
  • Schueler BA, Balter S, Miller DL. Radiation protec- tion tools in interventional radiology. J Am Coll Radiol 2012;9:844-5.
  • Blattert TR, Fill UA, Kunz E, Panzer W, Weckbach A, Regulla DF. Skill dependence of radiation exposure for the orthopaedic surgeon during interlocking nailing of long- bone shaft fractures: a clinical study. Arch Orthop Trauma Surg 2004;124:659–64.
  • Tuohy CJ, Weikert DR, Watson JT, Lee DH. Hand and body radiation exposure with the use of mini C-arm fluo- roscopy. J Hand Surg Am 2011;36:632–8.
  • Madan S, Blakeway C. Radiation exposure to surgeon and patient in intramedullary nailing of the lower limb. Injury 2002;33:723–7.
  • Seibert JA. Digital radiography: image quality and radia- tion dose. Health Phys 2008;95:586–98.
  • Kahler DM. Navigated long-bone fracture reduction. J Bone Joint Surg Am 2009;91 Suppl 1:102–7.
There are 38 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Gultekin Sitki Cecen This is me

Deniz Gulabi This is me

Gokhan Pehlivanoglu This is me

Guven Bulut This is me

Halil Bekler

Kiyasettin Asil

Publication Date July 17, 2015
Published in Issue Year 2015 Volume: 49 Issue: 3

Cite

APA Cecen, G. S., Gulabi, D., Pehlivanoglu, G., Bulut, G., et al. (2015). Radiation in the orthopedic operating theatre. Acta Orthopaedica Et Traumatologica Turcica, 49(3), 297-301. https://doi.org/10.3944/AOTT.2015.14.0250
AMA Cecen GS, Gulabi D, Pehlivanoglu G, Bulut G, Bekler H, Asil K. Radiation in the orthopedic operating theatre. Acta Orthopaedica et Traumatologica Turcica. July 2015;49(3):297-301. doi:10.3944/AOTT.2015.14.0250
Chicago Cecen, Gultekin Sitki, Deniz Gulabi, Gokhan Pehlivanoglu, Guven Bulut, Halil Bekler, and Kiyasettin Asil. “Radiation in the Orthopedic Operating Theatre”. Acta Orthopaedica Et Traumatologica Turcica 49, no. 3 (July 2015): 297-301. https://doi.org/10.3944/AOTT.2015.14.0250.
EndNote Cecen GS, Gulabi D, Pehlivanoglu G, Bulut G, Bekler H, Asil K (July 1, 2015) Radiation in the orthopedic operating theatre. Acta Orthopaedica et Traumatologica Turcica 49 3 297–301.
IEEE G. S. Cecen, D. Gulabi, G. Pehlivanoglu, G. Bulut, H. Bekler, and K. Asil, “Radiation in the orthopedic operating theatre”, Acta Orthopaedica et Traumatologica Turcica, vol. 49, no. 3, pp. 297–301, 2015, doi: 10.3944/AOTT.2015.14.0250.
ISNAD Cecen, Gultekin Sitki et al. “Radiation in the Orthopedic Operating Theatre”. Acta Orthopaedica et Traumatologica Turcica 49/3 (July 2015), 297-301. https://doi.org/10.3944/AOTT.2015.14.0250.
JAMA Cecen GS, Gulabi D, Pehlivanoglu G, Bulut G, Bekler H, Asil K. Radiation in the orthopedic operating theatre. Acta Orthopaedica et Traumatologica Turcica. 2015;49:297–301.
MLA Cecen, Gultekin Sitki et al. “Radiation in the Orthopedic Operating Theatre”. Acta Orthopaedica Et Traumatologica Turcica, vol. 49, no. 3, 2015, pp. 297-01, doi:10.3944/AOTT.2015.14.0250.
Vancouver Cecen GS, Gulabi D, Pehlivanoglu G, Bulut G, Bekler H, Asil K. Radiation in the orthopedic operating theatre. Acta Orthopaedica et Traumatologica Turcica. 2015;49(3):297-301.