Abstract
PURPOSE: To evaluate the impact of reducing protective equipment requirements on post-procedural infection rates in ultrasound-guided paracenteses, comparing outcomes between full protective equipment protocol (sterile gloves, gown, surgical mask, and hat) vs. limited protective equipment protocol (sterile gloves only).
MATERIALS AND METHODS: A single-center retrospective study analyzed 1,177 consecutive ultrasound-guided paracenteses performed between June 1st, 2021 and May 31st, 2022. The study compared infection rates across two six-month periods: before (619 procedures) and after (558 procedures) the 12/1/2021 policy change reducing protective equipment requirements. Primary outcome measures included post-procedural infection rates, specifically spontaneous bacterial peritonitis (SBP), soft tissue infection, or other intra-abdominal infections, evaluated at 7 and 14 days post-procedure. Analysis was conducted at both the individual paracentesis and patient level.
RESULTS: No statistically significant differences were observed in post-procedural infection rates between the full and limited protective equipment groups. The 7-day infection rates were 1.1% vs. 0.9% (p=0.41), and 14-day infection rates were 1.5% vs. 1.8% (p=0.65) for full versus limited protective equipment groups, respectively. Patient-level analysis showed similar results, with 14-day infection rates of 3.3% vs. 4.1% (p=0.69). The median volume of fluid removed remained consistent between groups (3.2L vs. 3.0L, p=0.50).
CONCLUSION: Sterile gloves alone provide adequate protection for ultrasound-guided paracentesis while reducing the use of protective equipment, enabling simplified protocols without compromising patient safety.