LocArm Holder- Helpful low cost Assistant for Disinfection in Hand Surgery Procedures

The article in Indian Journal of orthopedics by Francesco Costa et al describes an innovative easy-to-use and hands-free device that helps the surgeon during disinfection of the skin and the setup of the surgical field by keeping elevated the upper limb with respect for tissues.

Although there is no consensus regarding the best skin disinfection technique, whatever antiseptic solution is used, the "prep and drape" portion of most upper extremity procedures requires the presence of at least one operative room assistant or scrub nurse to elevate and hold the hand and forearm. Nonetheless, especially in a busy hand surgery practice and during fast procedures, an operative room assistant or scrub nurse are frequently not available leading to a reduced time efficiency between procedures.

The development of the surgical arm holder starts from three easily available and washable thermoplastic splint sheets. The design of the Surgical Arm Holder started from a parallelepiped measuring 40 cm large×25 cm high×15 cm deep with a hemispherical depression. A slightly tilted plane from distal to proximal in its superior side is created to accommodate the arm and determine an elevation of the limb above the surgical table. This shape is designed to be ergonomic and cozy, allowing for a comfortable positioning of different sizes and circumferences arms. The occupational therapist (OT) developed the model, while the technical design was realized by an architect.

A retrospective analysis of the "surgical malpractice claims" and institutional non-conformities registered was conducted in the hospital looking for bone or soft tissue complications related to the use of the device.

Three thousand one hundred eighty-seven surgical procedures were performed during study period using this device. The retrospective analysis of all "surgical malpractice claims" showed no skin lesions, no neurological complications (such as neuroapraxia), no need for secondary bone procedures or interference with the draping process.

The authors concluded that – The LocArm Holder is a low-cost, easy to manage and helpful solution to help the hand surgeon in the disinfection phase and could improve hospital preoperative flow, without the need of other staff members to be engaged in holding the limb during disinfection of the skin. Moreover, it reduces the potential risk of MSK injuries to the surgical staff by minimizing lift and holding time during surgical preparation of the upper extremity. It is a low-cost, resistant, washable, and easy-to-make device that may help surgeons to prepare the operatory field.

Further reading:

A Helpful Assistant for Disinfection in Hand Surgery Procedures: The LocArm Holder

Francesco Costa, Fimke Donati et al

Indian Journal of Orthopaedics (2022) 56:1813–1817

https://doi.org/10.1007/s43465-022-00660-1