C-Arm Drape Contamination: Why the Top of the Image Intensifier Poses the Greatest Risk
The C-arm is used in many surgical procedures-but its drape is a known high-risk area for sterile field contamination. One study found that 17% of C-arm drapes were contaminated immediately after initial draping. Within just 20 minutes, that number jumped to 50%, and by 80 minutes, 80% were contaminated.
Top C-Arm Contamination Risks
Risk #1: Lateral position changes of the C-arm pose an increased risk for sterile field contamination
Contamination is highest on the top of the image intensifier (see diagram), where it comes in close contact with the unsterile, undraped portions of the C-arm when the device is rotated into a lateral position. This is significant, Dr. Cahn explained, because the area of the sterile field closest to the image intensifier in lateral position—opposite where the surgeon typically stands—has also been reported as the most contaminated.
Risk #2: Raising the x-ray tube of the C-arm raises the sterile field drape from a contaminated area to the level of the sterile field
The x-ray tube of the C-arm carries a high risk of contamination due to how it moves from beneath the table to a position near the surgeon. As it swings upward, the drape is pulled from below the sterile field level to the level of the OR bed.
Tips to Minimize Risk of C-arm Drape and Sterile Field Contamination
- Drape the C-arm as close to the time of use as possible.
- Follow the drape manufacturer’s instructions for use.
- Treat the top of the C-arm drape as contaminated after draping.
- If a scrubbed person touches the C-arm drape or a drape used to protect the sterile field during lateral positioning, they should change gloves immediately afterward.
- Prevent the draped C-arm from contacting the patient or sterile field whenever possible.
