A simple and effective method of sterilizing Esmarch bandages

O’Hara, John N.; Coleman, Matthew; Hutton, Rachael

doi:10.1016/s0883-5403(11)80001-x

Cited by 11 publications

(6 citation statements)

References 1 publication

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“…1 The Esmarch bandage was found to be the most effective, but application is time-consuming and sterilisation is difficult. 12,13 Both the Esmarch and the gauze bandage may be contraindicated if a fracture is present or if the skin is delicate. The Urias bag is impractical; it takes time to apply and is not effective.…”

Section: Discussionmentioning

confidence: 99%

Exsanguination of the upper limb in healthy young volunteers

Blond

2002

The Journal of Bone and Joint Surgery. British volume

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U sing a scintigraphic technique based on an autologous injection of 99mTc-labelled erythrocytes, we have evaluated the efficiency of different exsanguination procedures in the upper limb of ten healthy male volunteers. The methods were elevation alone, the use of the Esmarch bandage or a gauze bandage, the Pomidor roll-cuff, the squeeze method and the Urias bag.The various procedures gave the following median percentage reductions of blood volumes: elevation for 5 seconds 44%, 15 seconds 45%, 30 seconds 46%, 60 seconds 46% and 4 minutes 42%, the Esmarch bandage 69%, a gauze bandage 63%, the Pomidor roll-cuff 66%, the squeeze method 53%, and the Urias bag 57%. With regard to elevation alone no significant differences were found. All the external methods were significantly more effective than elevation alone. Overall, the squeeze method was found to be the best method of exsanguination before inflation of a tourniquet, because it is effective, fast, practical and inexpensive. It is generally accepted that operations on the limbs are made easier by the use of a tourniquet. In order to reduce the amount of blood in the limb it is exsanguinated before the tourniquet is inflated. In a recent study we have compared different techniques of exsanguination of the lower limb 1 using a scintigraphic method. In this study we have evaluated various methods of exsanguination of the upper limbs including elevation alone, the use of bandages, the squeeze method, 7 the Urias bag 8,9 and elevation for longer than 30 seconds. Subjects and MethodsTen healthy male volunteers with a mean age of 26 years (20 to 34), a mean height of 186 cm (174 to 202) and mean weight of 86 kg (74 to 104) participated in the study. The local Ethical Committee approved the study and the subjects gave written informed consent. The method for the evaluation of changes in the blood volume was based on the autologous injection of 99m Tcradiolabelled erythrocytes and the use of a pneumatic tourniquet. 2 Each subject was placed supine with the arm on a gamma camera. A one-minute scintigram of the forearm and hand was obtained before and after exsanguination. In order to have a consistently reproducible position of a region of interest (ROI) for subsequent integration of radioactivity a 57Co source was placed 3 cm distal to the medial epicondyle of the humerus. For the ROI we used the smallest rectangle which included the right hand and the part of the right forearm distal to the marking. The same ROI was used for all measurements in each subject. Examples of scintigrams are given in Figure 1. The percentage reduction of blood volume was then calculated from counts obtained before and after exsanguination.The following types of exsanguination procedures were tested: elevation alone, the use of the Esmarch bandage, a gauze bandage, the Pomidor roll-cuff (Pomidor AB, Varnamo, Sweden), the squeeze method, and the Urias bag. For elevation the examiner lifted the arm to a vertical position for 5, 15, 30 and 60 seconds and 4 minutes, respectively. The external meth...

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Section: Discussionmentioning

confidence: 99%

Exsanguination of the upper limb in healthy young volunteers

Blond

2002

The Journal of Bone and Joint Surgery. British volume

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“…This has been confirmed by this study, as we were unable to achieve sterilization consistently in 8-10% of bandage rolls, despite more than doubling the number of super-atmospheric flushing waves (exceeding British Standard units). These results are reflected by O'Hara et al 5 in their study on sterilization of Esmarch bandages. They were unable to sterilize tightly wrapped or folded bandages, and it was only with the interposition of crepe bandage, to facilitate steam penetration, that sterility could be reliably achieved.…”

Section: Discussionmentioning

confidence: 68%

The sterility of hospital-prepared Soffban™ bandages

Wood

Fenwick

Manning

et al. 2005

Journal of Hospital Infection

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“…No bacterial growth was detected from samples after gravity displacement sterilization; however, this may reflect the small sample size (n = 5) we used and a larger number of bandage samples may yield different results. In the human literature, 3 studies have assessed the efficacy of steam sterilization (using a dynamic air removal autoclave or at 134–136°C at 2.3 bars for 3 minutes) of bandages with similar results: bandages remained contaminated in 8–10% of samples …”

Section: Discussionmentioning

confidence: 99%