To the Editor:—

When intraoperative transesophageal echocardiography is planned, baseline images are often desirable before surgical incision, especially if electronic suppression of electrocautery interference is not available. However, out of fear of droplet contamination of the operative field, we had been reluctant to manipulate the echo probe before completion of surgical prepping and draping. Now we secure an additional interference-free imaging opportunity by hanging a barrier drape across the chin of the patient before the surgical skin preparation is started (fig. 1). Commercially available transparent drapes bearing an adhesive strip are convenient for this purpose. Sternal wound infections are rare, and intraoperative echocardiography is not a quantitatively obvious risk factor. However, any plausible measure should be taken against so dreaded a potential complication. 1 


Borer A, Gilad J, Meydan N, Riesenberg K, Schlaeffer F, Alkan M, Schlaeffer P: Impact of active monitoring of infection control practices on deep sternal infection after open-heart surgery. Ann Thorac Surg 2001; 72: 515–20