Thyroid radiation shields: A potential source of intraoperative infection

Abstract

Introduction Thyroid radiation shields are often uncovered by the surgical gown and may represent a preventable source of wound contamination. The aims of this study are to define the common pathogens found on thyroid radiation shields and evaluate the effectiveness of a simple cleaning method. Methods Samples were obtained from 29 community thyroid shields collected from the operating theatres of 3 teaching hospitals. Each shield was swabbed under strict sterile technique using a separate swab for each of 4 designated zones. After sampling, shields were cleaned with a readily available disinfectant and sampling was repeated after 5 min. All swabs were cultured in ambient air at 37 °C on 5% sheeps blood agar for 48 hrs and subsequent growth was identified by a MALDI-TOF Walkaway mass spectrometer. Results Before cleaning, 100% of thyroid shields (29/29) and 68% of shield zones (79/116) grew at least 1 type of bacteria. Coagulase negative staphylococci, including S. epidermidis, S. capitis, S. cohnii, S. haemolyticus and S. hominis , were most commonly isolated. Enterobacteriaceae and S. aureus were also cultured. After cleaning, culturable contamination was reduced by 86.3% and 64.5%, respectively (p < 0.001). Conclusion The most common pathogens associated with SSIs can be isolated on thyroid radiation shields. Appropriate cleaning of thyroid shields with readily available disinfectant can significantly reduce the bacterial burden as detectable by culture. Hospitals should facilitate staff education and reinforce their policies on cleaning these shields which may often be overlooked.

Quality Assurance of Personal Radiation Shield for Kilovoltage Photon: A Multicentre Experience

“…More recently, bacterial contamination on protective shields was reported. 19 , 20 We therefore recommend, in accordance with recent international highlights, that a description of the physical appearance of shields and surface cleaning procedures should be included in the annual inspection files.…”

Staphylococcus capitis: Review of Its Role in Infections and Outbreaks

“…Medical equipment has been demonstrated to be a source for bacterial surface contamination both in NICU outbreaks and in adult settings. S. capitis has been identified on reusable electroencephalography cup electrodes and lead wires [ 96 ], thyroid radiation shields [ 97 ] and postsurgery anaesthetic syringes [ 98 ]. Slater et al [ 99 ] also reported S. capitis in 8 of 40 needleless connectors connected to peripheral IV catheters in adult medical patients in hospitals, with the authors highlighting the urgency of developing an effective needleless connector decontamination procedure [ 99 ].…”

Is It Appropriate to Completely Eliminate Contact Shielding during CT Examination? A Discourse Based on Experimental Findings

“…Contact shielding has the following additional drawbacks. First, direct contact of reused protective equipment with the patient's body surface may lead to infection, as demonstrated in a study that isolated gram-negative and gram-positive bacteria from cultures of protective equipment (McAleese et al 2020). The sharing of equipment among multiple users, bacterial contamination, and inadequate disinfection of personal protective equipment due to cross-use pose potential health hazards to patients (Ang et al 2018), such as lead scarves that shield the thyroid gland from direct skin contact, contamination sources are primarily concentrated around the neckline of the thyroid collar (Balter et al 2021).…”