OR light handle  

RE: OR light handle

Great job.  I have printed a couple replacement parts for work but not the OR.  I thought our infection control folks were going to have a stroke.    

RE: OR light handle

@cwbullet

It is just for animals 😉 (don´t take me serious) 

Best regards, Clemens

RE: OR light handle

I have a question for sterilization/cleaning;

Could parts be vaporsmoothed/resin/epoxi coated to make the surface homogenous (spelling?) enough to be considired safe after wipedown in those enviroments?

RE: OR light handle

@mrstoned

Smooth would definitely improve infection control.  

RE: OR light handle

@cwbullet

So the number of misunderstandings around what needs to be sterilized, etc in a medical setting is huge. So this light handle is not in the sterile OR (it's in a procedural area, where most of the surgical procedures done are non-sterile [like oral surgery]), and by the way actual sterile ORs are hardly sterile, we try to sterilize the field where we operate but in reality almost every surface of the room has bacteria on it (and the patient brings their own in). So in the sterile OR we use covers over the light handles with autoclaved plastic sleeves. I have done fully sterile prints before (for medical devices on FDA approved trials) in which case we autoclave them (the line of people who tell me you can't autoclave plastic is even longer than the first group of people - guys it's boiling water, i.e. around 115C, polycarbonate or nylon are just fine at that temperature [I mean I wouldn't place a structural load on it at those temps, but it's sitting on a shelf inside the machine]). These light handles are not sterile at all and are no different than the light switch that controls the light. If they wanted to do a sterile procedure here they would use the sterile bag sleeves we use for unsterile things in the sterile field (like ultrasound probes). Once in a while I have used the Ethylene Oxide sterilizer which doesn't care about small ridges or anything to kill because it is a gas and insanely toxic; however it isn't allowed on parts with an infill as the gas could enter via a pinhole and leach out later (it's both insanely toxic and highly explosive). So I only do it on 100% infill SLA prints. Given the SLA resins are often good to 400F I mostly autoclave but occasionally the thing based on the shape is better served by EthOx.

RE: OR light handle

@henryhbk

I am well aware of what needs steralized.  I am a physician.  In hospitals, Infection Control would baulk at any surface that is any semblance of porous.  I would not steralize the handle.  I would do what we should do and that is smooth surface as much as possible and use handle covers that are disposible.  

RE: OR light handle

Posted by: @cwbullet

@henryhbk

I am well aware of what needs steralized.  I am a physician.  In hospitals, Infection Control would baulk at any surface that is any semblance of porous.  I would not steralize the handle.  I would do what we should do and that is smooth surface as much as possible and use handle covers that are disposible.  

I mean as a physician myself I have had no problem getting past our Infection Control rules. On several projects they have requested testing of the surface (and I've always pointed out that their own infection control studies they talk about all the time demonstrated "smooth" plastics are hardly that at the bacterial scale (the phone handsets which are glossy smooth are famous fomites). I mean I test the things we use in the actual sterile OR via our microbiology lab and have yet to have a part fail sterilization (and I let the central sterilization guys do it, rather than in the lab). The surgical guides I work with are SLA printed in the approved formlabs SG resin, but to be honest under a microscope they are quite un-smooth (to the naked eye they look perfect), but they are single use anyway, so we autoclave them and we have not had an interaoperative infection from them. But again this handle just needs to be "clean" like the light switch on the wall...

RE: OR light handle

Thanks.

I was only asking for my own interest.

When i worked as a helper at a nursinghome, my job was to wipe down all "touch" surfaces atleast twice per day as well as tables, chairs etc.

First general gurpose cleaner, and surfacedisenfectant afterwards.

I understands this is different areas, but still within the healthcare and their set standards.

RE: OR light handle

@mrstoned

Yeah, and that is a good protocol, of getting it clean then disinfected. However disinfected and sterile are really different things. It is virtually impossible to get something sterile that is out in the air (I would hazard a guess if they cultured sterile surgical instruments sitting in the OR once they've had their package opened, they don't remain truly sterile for very long. The world is covered in bacteria, and we all just were designed to survive that. A lot of the "way things were done" fail when rigorously studies, such as the surgical hand scrubbing ritual. While probably a good ritual for getting mentally in the mode of being a surgeon, when studied it turned out to have no big advantage over sanitizer (I remember as a medical student doing hand prints on petri dishes and then doing a full surgical scrub and then repeating the culture. What we showed was basically it selected for bacteria that lived deeper in the skin (for better or worse). So several of out surgical specialties have switched over to just sanitizing foam (I think it is ethanol based with a quaternary ammonium compound in it) and we have not seen an uptick in surgical site infections. The huge advantage is speed, which when we are mostly doing robotic procedures reduces delays in the OR immensely as the surgeon switches back and forth from the robot console (not sterile).

RE: OR light handle

@mrstoned

That is similar to a hospital.  I m the CMO for a hospital with 58K beneficiaries.  

RE: OR light handle

Posted by: @cwbullet

@mrstoned

That is similar to a hospital.  I m the CMO for a hospital with 58K beneficiaries.  

When I started the pet-therapy program at our hospital (an 800 bed level-1 trauma center Harvard teaching hospital) there was a general freakout by a bunch of doctors (despite all of our neighboring hospitals having pet therapy with no adverse effects) that because the animals went room to room they would spread infection. I noted "well thank goodness we don't have any staff members who walk room to room touching patients" "but they hand-gel their hands" "sure, we can hand-gel the dogs, but what about the rest of staff members' bodies?" the head of ID noted that they were seriously unlikely to spread bacteria more than staff members, and as long as we didn't do therapy in rooms where people were on contact precautions for really spreadable organisms (easy enough to identify since there are signs on the door) and the dogs do hand-gel in and out of the rooms, and take chlorohexadine shampoos before coming to the hospital. We have had no attributable infections in the 12 years we have been running the pet therapy program. But numerous thank you letters from patient and families. I love when a big dog comes up to me when I'm working and gives me his business card (they have super cute business cards with their likes on them [playing fetch, etc]). Definitely puts a lift in your step.

RE: OR light handle

@henryhbk

Unless you are severely immunocompomised, humans are not very susceptible to animal infection unless there is a bite or scratch.  

RE: OR light handle

@cwbullet

Oh they weren't worried about patients getting dog infections (although they do carry a massive load of tetanus in their mouths and we can get some parasites from them - like Giardia - which i know since I got it from a lab accident at my wife's hospital when i was a med student - who leaves positive ceramic titer disks on the "clean counter"), the concern was that the dog's fur could act as a fomite when a patient petted them and then walked to the next room; there was particular concern at the time for Norovirus (which rips through out staff every winter except this one since we are heavily PPE'd up), MRSA, ESBL Klebsiella and VRE. I am sure a dog's fur will happily host Norovirus (like a doorknob will). Every cluster infection has been traced back to humans (staff) rather than the dogs.

RE: OR light handle

@henryhbk

That is what we refer to as a theoretical risk.  It happens but it rare and it does not pan out to beat the benefits of our fury friends.