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Related Experiment Video

Updated: Sep 26, 2025

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

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Changes in orthopaedic operating theatre practice, monitored using settle plates.

A M Thomas¹, Mac Wilkinson², M I Garvey²

¹Royal Orthopaedic Hospital, UK.

Annals of the Royal College of Surgeons of England

|April 20, 2022

Summary

This summary is machine-generated.

Implementing body exhaust systems significantly reduced airborne bacteria in operating theatres. This advancement in ultraclean air technology achieved colony counts of 0.03 colonies/plate/hour, crucial for preventing deep joint replacement infections.

Keywords:

Infection Joint replacement Operating theatre Settle plates

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Area of Science:

Orthopedic Surgery
Infection Control
Environmental Monitoring

Background:

Sir John Charnley demonstrated ultraclean air reduces deep infection rates in joint replacement surgery.
While early trials showed effectiveness, registry data have yielded inconsistent benefits.
This study aimed to assess theatre air quality in the context of treating rheumatoid arthritis patients.

Purpose of the Study:

To evaluate the impact of body exhaust systems on airborne bacterial load in a joint replacement theatre.
To determine if contemporary practices can achieve ultraclean air standards comparable to historical benchmarks.

Main Methods:

Air quality was monitored using settle plates in a joint replacement theatre over two phases.
Phase 1: Standard procedure without body exhaust systems.
Phase 2: All staff utilized body exhaust systems, with attention to surgical light and trolley positioning.

Main Results:

Phase 1 yielded 0.24 colonies/plate/hour, aligning with Charnley trial findings.
Phase 2 demonstrated a significant reduction to 0.03 colonies/plate/hour (p<0.001).
A tendency for colonies to appear on trolley edges was observed under controlled conditions.

Conclusions:

Contemporary surgical environments can achieve ultraclean air status.
The use of body exhaust systems by all team members is key to significantly reducing bacterial counts.
This method offers a viable strategy for minimizing deep infection risk in joint replacement surgery.