Surgical Space Suits Increase Particle and Microbiological Emission Rates in a Simulated Surgical Environment

Vijaysegaran, Praveen; Knibbs, Luke D.; Morawska, Lidia; Crawford, Ross

doi:10.1016/j.arth.2017.12.009

Cited by 19 publications

(5 citation statements)

References 31 publications

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“…Vijaysegaran et al compared particle and microbiologic emission rates from SHS and standard surgical clothing. 10 The authors found higher rates of both particle and microbiologic emission in SHS. Two studies assessed timing of surgical helmet fan activation and concluded that early activation prior to gown dressing increased contamination rates of both the surgeon and scrub nurse.…”

Section: Introductionmentioning

confidence: 94%

The Relationship between Bacterial Load and Initial Run Time of a Surgical Helmet

Lynch

Swanson

Marmor

et al. 2022

Journal of Shoulder and Elbow Arthroplasty

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Background Periprosthetic joint infection (PJI) is a complication of arthroplasty surgery with significant morbidity and mortality. Surgical helmets are a possible source of infection. Pre-existing dust and microorganisms on its surface may be blown into the surgical field by the helmet ventilation system. Methods Twenty surgical helmets at our institution were assessed through microscopy and polymerase chain reaction testing. Helmets were arranged with agar plates under the front and rear outflow vents. Helmets ran while plates were exchanged at different time points. Bacterial growth was assessed via colony counts and correlated with fan operating time. Gram staining and 16S sequencing were performed to identify bacterial species. Results The primary microbiological contaminate identified was Burkholderia. There was an inverse relationship between colony formation and fan operating time. The highest number of colonies was found within the first minute of fan operating time. There was a significant decrease in the number of colonies formed from the zero-minute to the three (27 vs 5; P = <.01), four (27 vs 3; P = <.01), and five-minute (27 vs 4; P = <.01) time points for the front outflow plates. A significant difference was also observed between the one-minute and four-minute time points ( P = .046). Conclusion We observed an inverse relationship between bacterial spread helmet fan operation time, which may correlate with dispersion of pre-existing contaminates. To decrease contamination risk, we recommend that helmets are run for at least 3 min prior to entering the operating room.

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Section: Introductionmentioning

confidence: 94%

The Relationship between Bacterial Load and Initial Run Time of a Surgical Helmet

Lynch

Swanson

Marmor

et al. 2022

Journal of Shoulder and Elbow Arthroplasty

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“… 17 In a recent study comparing particle and microbiological emission rates (PER and MER) between exhaust suits and conventional surgical clothing, exhaust suits had increased PER and MER. 18 While the study is confined to laboratory research, there is a potential risk of contamination to the surgical field due to air emanating from the joints of the suit or turbulence caused by the air expelled from the suit. Additionally, the reduced spatial awareness experienced by surgeons when wearing the suit may lead to inadvertent contamination, emphasizing the need for careful consideration in the use of exhaust suits.…”

Section: Three Main Sources Of Surgical Site Contaminationmentioning

confidence: 99%

Comprehensive Guidance for the Prevention of Periprosthetic Joint Infection After Total Joint Arthroplasty and Pitfalls in the Prevention

Parvizi,

Cha,

Chisari

et al. 2024

J Korean Med Sci

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Total joint arthroplasty (TJA) is a surgical procedure, in which parts of damaged joints are removed and replaced with a prosthesis. The main indication of TJA is osteoarthritis, and the volume of TJA is rising annually along with the increase of aged population. Hip and knee are the most common joints, in which TJAs are performed. The TJA prosthesis is composed of metal, plastic, or ceramic device. Even though TJA is the most successful treatment for end-stage osteoarthritis, it is associated with various complications, and periprosthetic joint infection (PJI) is the most serious complication after TJA. With the increasing volume of TJAs, there is a simultaneous rise in the incidence of PJI. Contamination of the surgical wound and the adherence of bacteria to the surface of prosthetic component represent the initial step in the pathogenesis of PJI. The main sources of the contamination are 1) patient's own flora, 2) droplets in the operation room air, and 3) surgical gloves and instruments. Even though modern techniques have markedly reduced the degree of contamination, TJAs cannot be done in completely germ-free conditions and some degree of contamination is inevitable in all surgical procedures. However, not all contamination leads to PJI. It develops when the burden of contamination exceeds the immune threshold or the colony forming units (CFUs) and various factors contribute to a decrease in the CFU level. Surgeons should be aware of the germ burden/CFU concept and should monitor sources of contamination to maintain the germ burden below the CFU to prevent PJI.

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“…Concern regarding gown-glove interface contamination has also been reported [52e54]. Two studies examining the New Zealand registry reported that the use of modern exhaust suit systems for primary THA and TKA was not significantly associated with reoperation for infection [55,56], and a paradoxical but nonsignificant trend toward an increased risk of reoperation in the primary TKA subset (odds ratio,1.53; 95% confidence interval,1.00-2.34) [55]. At the second ICM, in the absence of strong evidence, it was concluded that the use of personal protection suits does not reduce the rate of subsequent infection in patients undergoing TJA [57].…”

Section: Personal Protection Suitsmentioning

confidence: 99%

Intraoperative and Postoperative Infection Prevention

Goswami

Stevenson

Parvızı

2020

The Journal of Arthroplasty

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Surgical Space Suits Increase Particle and Microbiological Emission Rates in a Simulated Surgical Environment

Abstract: Space suits cause increased PER and MER compared with standard surgical clothing. This finding provides mechanistic evidence to support the increased prosthetic joint infection rates observed in clinical studies.

Cited by 19 publications

References 31 publications

The Relationship between Bacterial Load and Initial Run Time of a Surgical Helmet

The Relationship between Bacterial Load and Initial Run Time of a Surgical Helmet

Comprehensive Guidance for the Prevention of Periprosthetic Joint Infection After Total Joint Arthroplasty and Pitfalls in the Prevention

Intraoperative and Postoperative Infection Prevention

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