Assessment of Radiation Protection in Hand-Shielding Products With Mini C-Arm Fluoroscopy

Abstract

Background: Previous studies have highlighted the particular risk of radiation exposure to the surgeon’s hands with intraoperative fluoroscopy. Although evidence exists that shielding equipment for the hands reduces exposure, the extent of protection is not well understood. Therefore, we set out to determine the degree to which radiation exposure to the surgeon’s hands is decreased with hand-shielding products. Methods: An anthropomorphic model was positioned to simulate a surgeon sitting at a hand table. Thermoluminescent dosimeters were placed on the proximal phalanx of each index finger. The right index finger dosimeter was covered with a standard polyisoprene surgical glove (control arm), whereas the left index finger dosimeter was covered with commercially available hand-shielding products (study arm): lead-free metal-oxide gloves, leaded gloves, and radiation-attenuating cream. Mini fluoroscope position, configuration, and settings were standardized. The model was scanned for 15 continuous minutes in each test run, and each comparative arm was run 3 times. Results: The mean radiation dose absorbed by the control and variable dosimeters across all tests was 44.8 mrem (range, 30-54) and 18.6 mrem (range, 14-26), respectively. Each hand-shielding product resulted in statistically lower radiation exposure than a single polyisoprene surgical glove. Conclusions: The mean radiation exposure to the hands was significantly decreased when protected by radiation-attenuating options. Each product individually resulted in a statistically significant decrease in hand exposure compared with the control. We recommend that in addition to efforts to decrease radiation exposure, surgeons consider routine use of hand-shielding products when using mini c-arm fluoroscopy.