Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Minimal Incision Heel Spur Surgery Video

Posted by Joe S on 4/27/02 at 14:25 (081350)

Just watching the MIS Video performed by Dr. Zuckerman. I have a few concerns regarding his O.R. Technique.

1: His assistant is not gowned or using sterile gloves.
2: He is not wearing a surgical hood or mask.
3. He broke the sterile field when he grabbed the opposite foot and then went back to the surgical site and then stuck a bone rasp into the wound after touching it with his unsterile/contaminated hand.
4: This guys chance of infection is markedly higher.
5: Is that a garbage bag covering the head of the c-arm?

Ummmm, I don't know about you but I bet OSHA would have a field day in this office. I'm not critizing the surgery. I'm criticizing the OR Protocol. This is shoddy OR Technique at best. Anyone considering any surgical procedure should be operated on in either an Ambulatory Surgery Center or a Hospital OR. Even office based surgeons should adhere to strict infection control standards. Once you touch an unsterile object you are considered contaminated.

Re: Minimal Incision Heel Spur Surgery Video

Ed Davis, DPM on 4/30/02 at 14:34 (081809)

Where did the video come from?
Ed

Re: Minimal Incision Heel Spur Surgery Video

Dr. Zuckerman on 4/30/02 at 14:46 (081811)

The guy who did this surgery has a zero infection rate with this mis procedure. All instruments are sterile including the plastic bag. Both feet are washed. By the way ESWT has replaced this procedure

Re: Minimal Incision Heel Spur Surgery Video

Dr. Zuckerman on 4/30/02 at 14:49 (081813)

One last thing. OSHA has nothing to do with technique. Yes strict infection control is very important and I suggest you read about it yourself.

Re: Minimal Incision Heel Spur Surgery Video

Ed Davis, DPM on 4/30/02 at 14:55 (081815)

I have not seen the video -- not sure if it was a demonstration or an actual surgery. A assistant is only gowned if he or she is in the sterile field. The C-arm is covered with a sterile plastic cover-- I doubt that it is a garbage bag although plastic bags look like plastic bags...

Ed

Re: Minimal Incision Heel Spur Surgery Video

Joe S on 4/30/02 at 21:07 (081878)

Irregardless you still violate OR protocol. I can guarantee that this guy does not have a zero infection rate. There is no way anyone can have a zero infection rate period. It's just not possible. Maybe less than one percent but not Zero. Zero is an absolute number. By the way, I stand corrected. I watched the video again and the 'surgeon' did not stick the rasp back in the wound after touching the other foot. Also, even if the other foot was washed, it was still behind the 'sterile' barrier which is not sterile because it came in contact with his pants leg. That's a break in sterility as well. The assistant is not gowned and appears to be wearing plain exam gloves. From the video it's hard to tell but I don't see a typical betadine prep either. The foot is not your typical yellow brown discoloration. Maybe the surgeon used betasept or some other scrub. The actual procedure looks interesting though. I've never seen that approach for heel spur surgery. Do not get me wrong, I am not criticizing the procedure or the surgeon. I am criticizing the fact that there are certain standards in surgery which should be adhered too. Podiatrists are held to a different standard moreso than any other surgical specialty. You as pods know that. I'm sure some orthopods who might see this could probably use this against your profession. I'm Pro-Podiatry too. Anyway, my two cents...

Re: Minimal Incision Heel Spur Surgery Video

Joe S on 4/30/02 at 21:09 (081880)

Actually you are very right. OSHA has nothing to do with technique. They do have something to do with protection of your customers / patients and employees. I have read it. I have written an OSHA manual for my practice an am in compliance with it.

Re: Minimal Incision Heel Spur Surgery Video

Joe S on 4/30/02 at 21:15 (081883)

It was a live person and an actual surgery. C-Arm covers are clear. This looks like a plastic garbage bag. It may not be. But it looks like one. The video is available for download on this website. I am not attacking the surgeon. I am not attacking his technique. I could care less about the actual technique. Everyone is trained differently. I am trying to point out that in the eyes of another 'foot specialist' this video could be used against the podiatric profession to show pods operating in their offices not using proper OR protocol. That's all I'm saying. I think your surgery board what is it the American Board of Podiatric Surgery would look down on this type of OR protocol. I don't know. Maybe it's me.

Re: Minimal Incision Heel Spur Surgery Video

DR Zuckerman on 4/30/02 at 22:31 (081895)

The answer still is zero. I have never had a infecction in twenty two years with a mis heel spur procedure performed in this manner. I help to write the standard for this procedure and the procedure is sterile according to the standards. By the way next time you have a tooth pulled by your dentist take a picture of the draps, gowns he is wearing. By the way techicare is much more effective. then betadine scrub by you wouldn't know this . This is the end of this decisin its a waste. of time. BUT TELL ME THAT I DON'T HAVE A ZERO INFECTION RATE WITH THIS PROCEDURE because I do. Pro-podiatry that is so old. I would be happy to teach you proper technique for mis heel spur surgery if that is what you are looking. Call me Your make so many appear comments that just stop wasting my time.

Re: Minimal Incision Heel Spur Surgery Video

DR Zuckerman on 4/30/02 at 22:36 (081897)

So all covers that aren't clear are not sterile. Wow !!! You are really an observing person. Please don't assume anything in life unless you know

Re: Minimal Incision Heel Spur Surgery Video

Joe S on 5/01/02 at 07:04 (081917)

I waste no time my MIS friend. I do not need to know your technique. I am not criticizing you either. I am just merely stating the facts about proper sterile technique.

Re: Minimal Incision Heel Spur Surgery Video

Ed Davis, DPM on 4/30/02 at 14:34 (081809)

Where did the video come from?
Ed

Re: Minimal Incision Heel Spur Surgery Video

Dr. Zuckerman on 4/30/02 at 14:46 (081811)

The guy who did this surgery has a zero infection rate with this mis procedure. All instruments are sterile including the plastic bag. Both feet are washed. By the way ESWT has replaced this procedure

Re: Minimal Incision Heel Spur Surgery Video

Dr. Zuckerman on 4/30/02 at 14:49 (081813)

One last thing. OSHA has nothing to do with technique. Yes strict infection control is very important and I suggest you read about it yourself.

Re: Minimal Incision Heel Spur Surgery Video

Ed Davis, DPM on 4/30/02 at 14:55 (081815)

I have not seen the video -- not sure if it was a demonstration or an actual surgery. A assistant is only gowned if he or she is in the sterile field. The C-arm is covered with a sterile plastic cover-- I doubt that it is a garbage bag although plastic bags look like plastic bags...

Ed

Re: Minimal Incision Heel Spur Surgery Video

Joe S on 4/30/02 at 21:07 (081878)

Irregardless you still violate OR protocol. I can guarantee that this guy does not have a zero infection rate. There is no way anyone can have a zero infection rate period. It's just not possible. Maybe less than one percent but not Zero. Zero is an absolute number. By the way, I stand corrected. I watched the video again and the 'surgeon' did not stick the rasp back in the wound after touching the other foot. Also, even if the other foot was washed, it was still behind the 'sterile' barrier which is not sterile because it came in contact with his pants leg. That's a break in sterility as well. The assistant is not gowned and appears to be wearing plain exam gloves. From the video it's hard to tell but I don't see a typical betadine prep either. The foot is not your typical yellow brown discoloration. Maybe the surgeon used betasept or some other scrub. The actual procedure looks interesting though. I've never seen that approach for heel spur surgery. Do not get me wrong, I am not criticizing the procedure or the surgeon. I am criticizing the fact that there are certain standards in surgery which should be adhered too. Podiatrists are held to a different standard moreso than any other surgical specialty. You as pods know that. I'm sure some orthopods who might see this could probably use this against your profession. I'm Pro-Podiatry too. Anyway, my two cents...

Re: Minimal Incision Heel Spur Surgery Video

Joe S on 4/30/02 at 21:09 (081880)

Actually you are very right. OSHA has nothing to do with technique. They do have something to do with protection of your customers / patients and employees. I have read it. I have written an OSHA manual for my practice an am in compliance with it.

Re: Minimal Incision Heel Spur Surgery Video

Joe S on 4/30/02 at 21:15 (081883)

It was a live person and an actual surgery. C-Arm covers are clear. This looks like a plastic garbage bag. It may not be. But it looks like one. The video is available for download on this website. I am not attacking the surgeon. I am not attacking his technique. I could care less about the actual technique. Everyone is trained differently. I am trying to point out that in the eyes of another 'foot specialist' this video could be used against the podiatric profession to show pods operating in their offices not using proper OR protocol. That's all I'm saying. I think your surgery board what is it the American Board of Podiatric Surgery would look down on this type of OR protocol. I don't know. Maybe it's me.

Re: Minimal Incision Heel Spur Surgery Video

DR Zuckerman on 4/30/02 at 22:31 (081895)

The answer still is zero. I have never had a infecction in twenty two years with a mis heel spur procedure performed in this manner. I help to write the standard for this procedure and the procedure is sterile according to the standards. By the way next time you have a tooth pulled by your dentist take a picture of the draps, gowns he is wearing. By the way techicare is much more effective. then betadine scrub by you wouldn't know this . This is the end of this decisin its a waste. of time. BUT TELL ME THAT I DON'T HAVE A ZERO INFECTION RATE WITH THIS PROCEDURE because I do. Pro-podiatry that is so old. I would be happy to teach you proper technique for mis heel spur surgery if that is what you are looking. Call me Your make so many appear comments that just stop wasting my time.

Re: Minimal Incision Heel Spur Surgery Video

DR Zuckerman on 4/30/02 at 22:36 (081897)

So all covers that aren't clear are not sterile. Wow !!! You are really an observing person. Please don't assume anything in life unless you know

Re: Minimal Incision Heel Spur Surgery Video

Joe S on 5/01/02 at 07:04 (081917)

I waste no time my MIS friend. I do not need to know your technique. I am not criticizing you either. I am just merely stating the facts about proper sterile technique.