Design of an ultraportable surgical enclosure for low resource environments

Abstract

Access to surgical care for people in remote settings and/or developing countries is limited: 30% of the world's population receives 75% of major operations [1]. In developing countries, up to a third of patients acquire a surgical site infection (SSI), which is nine times more likely than in developed countries [2]. An estimated 85,500 cases of HIV and hepatitis are contracted by obstetrical/gynecological providers every year, and 90% of those cases are the result of treating patients living in poverty. SurgiBox aims to address these issues by providing a portable, sterile operating environment for use in austere settings. Not only are patients protected from environmental hazards through the use of SurgiBox, but medical personnel are also shielded from patient fluids, blood, and aerosols. SurgiBox consists of a clear, disposable plastic enclosure that is adhered to the patient's surgical site and inflated with filtered air. Long gloves, similar those used in a glovebox, are integrated into the enclosure and used by the medical personnel to perform the surgery. Surgical instruments are sterilized before the surgery and are placed inside the enclosure prior to the procedure, but materials, or even a baby in the case of a cesarean section, can be passed in or out of the sterile field during the procedure through a resealable port. Particle count testing inside the enclosure shows that particle counts could be maintained at less than 25% of operating room standards for particles greater than 0.5 microns (OR standard: less than 83,000 particles/m3)and 0.3 microns (OR standard: less than 1,000,000 particles/m 3 ).