Surgeon's garb and infection control: What's the evidence?

Eisen, Daniel B.

doi:10.1016/j.jaad.2010.04.037

Cited by 47 publications

(37 citation statements)

References 122 publications

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“…Tight masks and hoods rub against the skin, thereby increasing the shedding of contaminated particles. Their use in combination with laminar airflow may result in 3-to 5-fold increases in CFU/m 3 values and in a nearly 60-fold increase in the number of settled bacteria [24]. When combined with laminar airflow, a total body suit was not superior over a conventional disposable non-woven gown [25] in decreasing air contamination [6].…”

Section: Operating Room (Or) Attirementioning

confidence: 97%

“…However, the usefulness of surgical masks, hoods covering the hair (a major location for staphylococci), and shoe covers during conventional surgical procedures has been challenged [24]. OR garments should optimally be sealed by elastics at the waist, ankles, neck, and wrists to avoid the shedding of skin squames; • the surgical staff should wear disposable impermeable garments made of non-woven fabric, which should be tightened depending on the material used (polypropylene or Gore-Tex) [25].…”

Section: Operating Room (Or) Attirementioning

confidence: 99%

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Preventing surgical-site infections: Measures other than antibiotics

Chauveaux

2015

Orthopaedics & Traumatology: Surgery & Research

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Surgical-site infections (SSIs) due to intra-operative contamination are chiefly ascribable to airborne particles carrying microorganisms, mainly Staphylococcus aureus, which settle on the surgeon's hands and instruments. SSI prevention therefore rests on minimisation of airborne contaminated particle counts, although these have not been demonstrated to correlate significantly with SSI rates. Maintaining clear air in the operating room classically involves the use of ultra clean ventilation systems combining laminar airflow and high-efficiency particulate air filters to create a physical barrier around the surgical table; in addition to a stringent patient preparation protocol, appropriate equipment, and strict operating room discipline on the part of the surgeon and other staff members. SSI rates in clean surgery, although influenced by the type of procedure and by patient-related factors, are consistently very low, of about 1% to 2%. These low rates, together with the effectiveness of prophylactic antibiotic therapy and the multiplicity of parameters influencing the SSI risk, are major obstacles to the demonstration that a specific measure is effective in decreasing SSIs. As a result, controversy surrounds the usefulness of many measures, including laminar airflow, body exhaust suits, patient preparation techniques, and specific surgical instruments. Impeccable surgical technique and operating room behaviour, in contrast, are clearly essential.

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Section: Operating Room (Or) Attirementioning

confidence: 97%

Section: Operating Room (Or) Attirementioning

confidence: 99%

Preventing surgical-site infections: Measures other than antibiotics

Chauveaux

2015

Orthopaedics & Traumatology: Surgery & Research

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“…• l'obligation du port de tenues spéciales de bloc, même si l'intérêt de l'utilisation par le personnel de salle de masques chirurgicaux, de cagoules cachant les cheveux, site important de présence de staphylocoques, et même de couvre-chaussures a pu être remis en question en chirurgie conventionnelle [24]. Au mieux, ces tenues devront être fermés par des élastiques au niveau de la taille, des chevilles, du cou, des manches pour éviter le relargage de squames cutanées ; • concernant l'équipe chirurgicale, l'utilisation de vêtements à usage unique, en non tissé, imperméables, à ajuster en fonction du matériau utilisé (polypropylène, gore-tex) [25].…”

Section: Certains éLéments Sont Indiscutablesunclassified

“…L'utilisation de tels équipements combinée à celle d'un flux laminaire augmenterait de 3 à 5 fois le nombre de CFU/m 3 et de près de 60 fois le nombre de bactéries déposées [24]. Le port de masques et cagoules ajustés est générateur, par frottement cutané, de relargages accrus de particules contaminées.…”

Section: Certains éLéments Sont Indiscutablesunclassified

Prévention de l'infection en salle d'opération excluant l'antibiothérapie

Chauveaux¹

2014

Conférences d'Enseignement 2014

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“…Examples including using shoe covers, scrubs not leaving the operating theater, and even wearing surgical masks have limited or no significant data to support them; one large prospective randomized clinical trial of performing surgery with and without surgical masks showed that it made no difference. 4 This article discusses several of the interventions that have adequate studies to evaluate their effectiveness.…”

mentioning

confidence: 99%