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Hand Radiation-Attenuating Shielding Options: Is Hand Radiation Exposure Decreased
Matt Cantlon, MD, Asif Ilyas, MD
Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA
Introduction: 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, widespread adoption has not been observed. We examined the degree to which radiation exposure to the surgeon’s hands is decreased with various hand shielding products.
Methods: An anthropomorphic model (Figure 1) was positioned to simulate a surgeon sitting at a hand table with its hands flanking a volar plated distal radius sawbone. Thermoluminescent dosimeters were placed on the proximal phalanx of each index finger. In all tests, the right index finger dosimeter was covered with a standard polyisoprene surgical glove (control arm) while the left index finger dosimeter was covered with various commercially available hand shielding products (study arm), consisting of: lead-free metal-oxide gloves, leaded gloves, and radiation attenuating cream (Figure 2). Mini fluoroscope position, configuration and settings were standardized (Figure 1) and the model was scanned for 15 continuous minutes in each of the test runs. Descriptive statistics were performed.
Results: The mean radiation dose absorbed by the control and variable dosimeters across all tests was 44.8mrem (range 30-54) and 18.6mrem (range 14-26), respectively (p<0.005). Each hand shielding product resulted in lower radiation exposure than a single polyisoprene surgical glove.
Conclusion: The mean radiation exposure to the hands was significantly decreased when protected by the radiation-attenuating hand shielding options. Each product individually resulted in decreased hand exposure as compared to the control. We recommend that, in addition to standard efforts to decrease radiation exposure, surgeons consider the routine use of hand shielding products.
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