11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 ePosters 92 486 Intra-Operative Wound Irrigation with Povidone-iodine: a review. Ludovica Gatti1, Francesca Marzano1, Ilaria Franconi1 1Reunited Hospitals Torrette of Ancona, Blocco operatorio materno infantile Salesi, Ancona, Italy Background: During open procedures, it is common practice for surgeons to use fluids irrigations, both intra abdominal, and before the closure of the incision. This practice is generally used to clear tissues from residues or biological fluids and to decrease the risk of Surgical Site Infections (SSI). The most frequently used Intra-Operative Wound Irrigation (IOWI) is saline solution or saline solution with antiseptic agents/antibiotics. Povidone-iodine (PI) is recommended for the prevention of SSI for his bactericidal ability against a large array of pathogens. While most of the literature refer to its use topically, there are no official recommendations of its use in IOWI and there are general doubts about its potential cytotoxicity. Objectives: The aim of this literature review is to find scientific evidence supporting the clinical practice of IOWI-PI. Methods: The foreground question was formulated using the PICO method, and the review was conducted using the advanced search engine in the PubMed/Medline database. We used a combination of two keywords,: “Iodine Irrigation” and “Infection”. We have selected only clinical, randomized controlled trials from 2013 to 2024. Results: We obtained a total of 724 items. We included 30 studies in the review. The results are summarized qualitatively in a table: 14 studies adhere to the inclusion criteria. The most analyzed studies showed no significant benefits of rate of SSIs comparing IOWI treatment with PI and saline solution and treatment without irrigation. No studies investigated the potential cytotoxicity risk associated with the IOWI-PI. Conclusion: There are no standard guidelines for IOWI (fluid type, additives, contact time, washing volume) for best practice to guide operating room nurses and surgeons. According to the review and the World Health Organization (WHO) Guidelines for SSIs, the use of IO-PI needs to be developed and specific studies and recommendations need updating to define a clinical standard. 491 Teamwork in patient positioning Özge Coskun1, Renée Mumm Hansen1 1Rigshospitalet, Orthopedic surgical department, København Ø Background: Positioning of surgical patients is crucial to avoid or minimize positioning injuries. At Rigshospitalet orthopedic surgical department the mobile CT scanner AIRO is used, which comes with a special positioning aid. The CT scanner is used perioperatively for patients with severe spinal deformities who are positioned on the corresponding aid. It is essential that patients are positioned correctly, and that the entire patient’s spine can be scanned. At the same time, there must be space for various equipment on the bed. It is a complex positioning, and many factors must come together for everything to work. Objectives: The aim of the study is to implement a working document as a tool for positioning patients. The tool can be used by nurses who are not experienced in using AIRO, as well as nurses who need to train a colleague in using AIRO. In the development of the tool, anaesthetist nurses, operating room nurses, surgeons, porters, and neurophysiology assistants were involved. It is a one-pager with several points of attention when positioning in the specified aid. After the patient is positioned, a positioning check is performed, where a nurse reads out, and the entire team systematically goes through it. Conclusion: The working document is currently in the testing phase. The goal for this implementation is to avoid inappropriate positions where the entire patient’s spine cannot be scanned, and there is no room for the surgical team to stand around the bed. With this checklist there will also be a focus on the positioning to prevent any bearing damage. Furthermore the expectations for the working document is to support the coordination in the team and simultaneously ensure patient safety and assist in staff training.
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