Fluorescence labeling for simulation of contamination with operators and their surroundings during debridement and dressing

OBJECTIVE To stimulate the debridement and dressing process under the approximately real clinical scene by fluorescence labeling and understand the contamination status of the operators′ bodies and their surroundings so as to improve the strategies.

METHODS A total of 41 trainees were recruited from Enterostomal Therapist Nursing Education Program of Peking University School of Medicine and International School of Wound Therapists of Peking University First Hospital in 2023. The examination was designed by stimulating the debridement and dressing operations with fluorescence labeling, the orange was used to simulate the wound of the patients, and the pad towel was placed under the orange to represent the contaminated surroundings of the wound. A round lesion area with diameter of 2 cm was uniformly marked on the surface of the orange peel by the operators, the trainees were asked to remove the lesion tissues and take dressings. The fluorescent powders were smeared evenly on the orange and pad towel before the examination, and no fluorescence labeling for the surroundings was guaranteed. The trainees were required to wear hats, masks, isolation gowns and gloves during the operations, and take off the gloves and trace the scope of fluorescent contamination with ultraviolet radiator after the examination.

RESULTS The contamination rate was 92.68% for the trainees′ bodies, 100.00% for their surroundings. The hands and forearms were the most severe contaminated body sites, and the contamination rates were 85.37% (35/41) and 34.15% (14/41), respectively. The downside of the pad towel was the most frequently contaminated area of the surroundings, with the proportion of 90.24% (37/41); the right side of the pad towel was the area with the contamination disseminated farthest, with the median distance of dissemination 13.50 cm. In addition, the dressing change carts of 75.61%(31/41) of the trainees were contaminated.

CONCLUSIONS The operations of debridement and dressing change may lead to varying degrees of contamination of their bodies and surroundings. It is necessary to strengthen the hand hygiene and protective isolation during the process of dressing change and pay attention to the disinfection of the dressing change carts so as to minimize the risk of hospital-associated infections.