Surgical face masks in modern operating rooms—a costly and unnecessary ritual?

Mitchell, Nicole; Hunt, Samantha

doi:10.1016/0195-6701(91)90148-2

Cited by 77 publications

(41 citation statements)

References 5 publications

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“…49 Of note, it is important to change face masks after each case, because it has been shown that once face masks become damp, bacteria are able to penetrate the mask. 12 Double gloving is another procedure that nearly all surgeons comply with, but is especially imperative for total joint arthroplasty.…”

Section: Operative Dressmentioning

confidence: 99%

Prevention methodologies against infection after total joint arthroplasty

Kapadia¹,

Johnson²,

Issa³

et al. 2012

Current Orthopaedic Practice

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Surgical site infections after lower extremity total joint arthroplasty procedures remain a substantial economic burden to the patient, the treating institution, and the healthcare system. The complexity of these surgical procedures creates the potential for various patient-related or surgery-related risk factors for infection. Although there is much literature regarding the use of many preventative methods, a consensus regarding the true efficacy and application of such practices generally is not available. In this review, we evaluated selected preventative measures including: the Centers for Disease Control and Prevention recommendations, skin preparation techniques, surgical draping techniques, operative dress, operating room ventilation, hair removal techniques, as well as operating room traffic control. Our literature review consisted of searching PubMed, EMBASE, Ovid, and other relevant orthopaedic journal databases. Preference was given to randomized-controlled trials, data from national registries, and meta-analyses within the past 5 years written in the English language. After reviewing the available literature, we present the authors' current preferred infection prevention methodology and protocol.

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Section: Operative Dressmentioning

confidence: 99%

Prevention methodologies against infection after total joint arthroplasty

Kapadia¹,

Johnson²,

Issa³

et al. 2012

Current Orthopaedic Practice

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“…However, studies fail to show any efficacy for this indication. [85][86][87] Only one randomly controlled clinical trial reported high infection rates after gynaecological and abdominal surgery-three of five women developed infection in the "no mask" group compared with no infections in the four women operated on by a masked surgeon. 88 Guidelines have recommended medical masks for use in operating theatres to protect staff from the splash and spray of blood and body fluids.…”

Section: Stat E O F T H E a Rt R Ev I E Wmentioning

confidence: 99%

Facemasks for the prevention of infection in healthcare and community settings

MacIntyre

Chughtai

2015

BMJ

282

304

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Facemasks are recommended for diseases transmitted through droplets and respirators for respiratory aerosols, yet recommendations and terminology vary between guidelines. The concepts of droplet and airborne transmission that are entrenched in clinical practice have recently been shown to be more complex than previously thought. Several randomised clinical trials of facemasks have been conducted in community and healthcare settings, using widely varying interventions, including mixed interventions (such as masks and handwashing), and diverse outcomes. Of the nine trials of facemasks identified in community settings, in all but one, facemasks were used for respiratory protection of well people. They found that facemasks and facemasks plus hand hygiene may prevent infection in community settings, subject to early use and compliance. Two trials in healthcare workers favoured respirators for clinical respiratory illness. The use of reusable cloth masks is widespread globally, particularly in Asia, which is an important region for emerging infections, but there is no clinical research to inform their use and most policies offer no guidance on them. Health economic analyses of facemasks are scarce and the few published cost effectiveness models do not use clinical efficacy data. The lack of research on facemasks and respirators is reflected in varied and sometimes conflicting policies and guidelines. Further research should focus on examining the efficacy of facemasks against specific infectious threats such as influenza and tuberculosis, assessing the efficacy of cloth masks, investigating common practices such as reuse of masks, assessing compliance, filling in policy gaps, and obtaining cost effectiveness data using clinical efficacy estimates.

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“…N95 filtering face-piece respirators (from here on referred to as "N95 respirators") are designed for respiratory protection and defined by their filtration capacity (2), which is higher than that of medical masks (3)(4)(5). The original purpose of medical masks was to prevent microbial contamination of wounds while worn by surgeons during surgery (hence their common name "surgical masks"), yet randomized controlled trials show no efficacy against wound contamination (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

A Randomized Clinical Trial of Three Options for N95 Respirators and Medical Masks in Health Workers

MacIntyre

Wang

Seale

et al. 2013

Am J Respir Crit Care Med

181

232

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Continuous use of N95 respirators was more efficacious against CRI than intermittent use of N95 or medical masks. Most policies for HCWs recommend use of medical masks alone or targeted N95 respirator use. Continuous use of N95s resulted in significantly lower rates of bacterial colonization, a novel finding that points to more research on the clinical significance of bacterial infection in symptomatic HCWs. This study provides further data to inform occupational policy options for HCWs. Clinical trial registered with Australian New Zealand Clinical Trials Registry http://www.anzctr.org.au (ACTRN 12609000778280).

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Surgical face masks in modern operating rooms—a costly and unnecessary ritual?

Cited by 77 publications

References 5 publications

Prevention methodologies against infection after total joint arthroplasty

Prevention methodologies against infection after total joint arthroplasty

Facemasks for the prevention of infection in healthcare and community settings

A Randomized Clinical Trial of Three Options for N95 Respirators and Medical Masks in Health Workers

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