Splash in elective primary knee and hip replacement: are we adequately protected?

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Surgical Safety

Background:

• Intra-operative splashes during total knee replacement (TKR) and total hip replacement (THR) are frequent.
• These splashes pose a significant risk for transmitting bloodborne pathogens to surgical staff and patients.
• Current protective measures, such as visor masks, may be insufficient.

Purpose of the Study:

• To quantify the risk of intra-operative splashes in elective TKR and THR.
• To assess the correlation between splash occurrence and patient body mass index (BMI), surgery duration, and lavage fluid volume.
• To evaluate the effectiveness of standard protective equipment.

Main Methods:

• A prospective study involving 62 patients undergoing elective TKR or THR.
• Data collection on patient BMI, surgery duration, and volume of pulse lavage fluid used.
• Observation and recording of intra-operative splash events.

Main Results:

• Splashes occurred in all 62 surgical cases.
• A statistically significant correlation was found between splash occurrence and surgery duration (r=0.52) and pulse lavage volume (r=0.92).
• No significant difference in splash risk was observed between TKR and THR (p=0.27).

Conclusions:

• Intra-operative splashes are a universal event in TKR and THR procedures.
• Lavage fluid volume and surgery duration are critical factors influencing splash generation.
• Standard visor masks offer inadequate protection against splashes and reverse splashes.