Ann Thorac Surg 2007;84:2125-2126. doi:10.1016/j.athoracsur.2007.03.074
© 2007 The Society of Thoracic Surgeons
How To Do It
A Simple Method for Making Photographic Records Under Sterile Conditions
Chiung-Lun Kao, MDa,
Bor-Chih Cheng, MDb,
Ming-Shian Lu, MDa,
Yu-Yun Nan, MDa,
Jen-Ping Chang, MDc,*
a Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital at Chiayi, Chang Gung Institute of Technology, Chiayi, Taiwan, R.O.C
b Chi Mei Medical Center, Tainan, Taiwan, R.O.C
c Chang Gung Memorial Hospital–Kaohsiung Medical Center, Chang Gung University, Medical College, Kaohsiung, Taiwan, R.O.C
Accepted for publication March 23, 2007.
* Address correspondence to Dr Chang, Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital–Kaohsiung Medical Center, Chang Gung University, Medical College, 123 Ta-Pei Rd, Niao Sung Hsiang, Kaohsiung, Hsien, Taiwan, 833, ROC (Email: c9112772{at}adm.cgmh.org.tw).
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Abstract
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Digital photography has become a practical alternative to conventional film photography for medical documentation, communication, and education. The use of digital cameras has become increasingly popular in recent years for documenting perioperative conditions, intraoperative findings, and imaging studies. However, taking intraoperative pictures or video clips may be technically demanding for assistants or nurses. Herein, we describe a simple and effective method for surgeons to create photographic and video records of operations under sterile conditions involving the use of a digital camera encased in commercially available protective housing.
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Introduction
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With the recent widespread availability of digital cameras, their use by clinical physicians to create visual records of operations has rapidly grown. The chief appeals of digital photography are the facility of long-term storage, retrieval, and database organization [1]. Digital cameras may be used to document preoperative and postoperative conditions, intraoperative findings, and imaging studies. Although a variety of systems for intraoperative photography and movie making have been developed, they often require the support of professional technicians [2]. Furthermore, in using these systems, discrepancies between the records created by assistants and those desired by the surgeon are inevitable. Herein, we describe a simple technique for surgeons to create photographic records without assistance.
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Technique
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We used a Samsung Digimax i5 digital camera and a Samsung SPH-A3 Waterproof Housing (Samsung, Kyunggido, Korea) to complete this design. The protective housing is specific to the camera model (Digimax i5; Samsung), and its constructed form of polycarbonate material. Preoperatively, the protective housing was sterilized with the STERRAD 100S system (Advanced Sterilization Products, Irvin, CA), which uses gas plasma technology to achieve sterilization.
During the operation, the protective housing was removed from the aseptic envelop in accordance with standard procedures for re-sterilized equipment in an operating room. The circulating nurse placed the digital camera into the sterilized protective housing (Fig 1), and the scrub nurse locked the housing buckle. The camera was then ready to record digital photographs and video footages in the operating room. The assistance of a professional photographer was not required. With these precautions, the surgeon could handle the camera to take intraoperative images at his convenience without risk of contamination (Fig 2). Using this particular method the surgeon did not lose valuable intraoperative information through misdirected or inaccurate shots.
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Fig 1. Photograph showing the circulating nurse placing the digital camera into the sterilized protective housing.
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After the operation the protective housing was re-sterilized and prepared for consecutive use.
During a 3-month period this method was used to record a range of operative images that were subsequently transferred to a computer database. A total of 967 digital images were recorded; of these, 901 were still photographs and 66 were video clips. No procedure-related infection in this particular patient population was noted. These digital images were used for teaching purposes, publications, and patient records.
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Comment
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Digital photography has become an affordable and financially beneficial alternative to conventional 35-mm photography in plastic surgery [1]. Digital cameras make it easy to record radiographic studies, operative fields, operative specimens, and patients in the clinical setting. We are unaware of any publication regarding this subject in existing cardiovascular literature, although intraoperative photographs and video clips are critical to surgical education, presentation, and publication.
The underwater protective housing used in this example is designed for a specific camera for the capture of underwater shots and use during inclement weather. This protective housing is a precision device constructed from a super-strong polycarbonate material with a buckle-type lock that creates a very secure seal. Full remote control of camera functions is possible through the outside console buttons. The procedures required for installation are quick and easy. Most importantly, this device is readily available at a low cost.
Using the macro-mode function of the digital camera, it is not difficult to focus and take photographs of objects from a distance of less than 5 inches. Such a camera permits publication quality close-up images of small objects, such as an intracardiac lesion in an operative field [3]. Surgeons can take photos of small targets in the operative field without risk of contamination by using our method.
The protective housing is suitable for re-sterilization. In our hospital, the housing is sterilized with the STERRAD 100S system (Advanced Sterilization Products), which uses gas plasma technology to provide dry, low-temperature (40°C) sterilization of both heat-stable and heat-sensitive and moisture-sensitive instruments.
In conclusion, using a digital camera encased by sterilized waterproof housing, we were able to take high-quality intraoperative photographs and video clips without assistance, thus precluding the possibility of losing valuable intraoperative information through the involvement of an outside party.
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References
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- Galdino GM, Swier P, Manson PN, Vander Kolk CA. Converting to digital photography: a model for a large group or academic practice Plast Reconstr Surg 2000;206:119-124.
- Windsor JS, Rodway GW, Middleton PM, McCarthy S. Digital photography Postgrad Med J 2006;82:688-692.[Abstract/Free Full Text]
- Andres BM, Khanna AJ, Wenz Sr JF, Faust AF, Frassica FJ. A comparison of digital cameras: features essential for the orthopedic surgeon Clin Orthop Relat Res 2004;421:10-16.[Medline]
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Abstract
Introduction
