Surgical Helmets Used During Total Joint Arthroplasty Harbor Common Pathogens: A Cautionary Note

Area of Science:

• Orthopedic Surgery
• Infection Control
• Microbiology

Background:

• Personal-protection surgical helmet/hood systems are standard in North American arthroplasty.
• No established protocols exist for disinfecting these surgical helmets.

Purpose of the Study:

• To assess bacterial contamination on surgical helmets and personnel foreheads.
• To evaluate the efficacy of hypochlorite spray for helmet disinfection.

Main Methods:

• Prospective, single-center observational study.
• Swabbing of 44 surgical helmets and 44 foreheads at three time points.
• Culture and next-generation sequencing (NGS) for bacterial identification; hypochlorite spray efficacy tested.

Main Results:

• 73% of helmet cultures and 71% of helmet NGS showed bacteria; 93% of forehead cultures and 78% of forehead NGS showed bacteria.
• Commonly identified bacteria included Cutibacterium acnes and Staphylococcus epidermidis.
• Hypochlorite spray effectively eliminated bacteria from helmets.

Conclusions:

• Surgical helmets harbor pathogens that can lead to surgical site infections.
• Development of disinfection protocols for surgical helmets is imperative.