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Patient draping and staff clothing in the operating theatre: a microbiological study
Abstract:
Fallout of bacteria and contamination at the wound site were studied during a standardized orthopaedic operation using sedimentation plates and a bacterial sampler. The procedure was performed in either a conventionally ventilated operating theatre or in an ultraclean air enclosure. The staff was dressed in either an all-cotton system (working clothes and theatre gown) or cotton working clothes in combination with Ventile theatre gown, or a laminate disposable theatre gown, or finally a polypropylene coverall and a laminate theatre gown. The patients were draped in cotton or laminate. The study was done during 5 periods. The most striking effect was seen when the combination of the coverall and the laminate theatre gown was used. The fallout in the conventional theatre was then at the same level as in the ultraclean air. It was even less than using Ventile gowns and laminate drapes in ultraclean air. The contamination at the wound site showed the same pattern. However, least contamination was recorded when laminate gowns and laminate drapes were used in ultraclean air.
Insights
Using advanced surgical attire, including laminate gowns and coveralls, significantly reduced bacterial contamination in operating rooms. This finding is crucial for enhancing patient safety during orthopedic surgery.
Area of Science:
- Microbiology
- Surgical Technology
- Infection Control
Background:
- Bacterial contamination in operating rooms poses a significant risk to patient outcomes.
- Standard operating procedures and attire may not sufficiently minimize microbial shedding.
Purpose of the Study:
- To evaluate the impact of different surgical attire and ventilation systems on bacterial fallout during orthopedic surgery.
- To determine the most effective combination of protective clothing and environmental controls for reducing wound contamination.
Main Methods:
- Bacterial contamination was assessed using sedimentation plates and a bacterial sampler during standardized orthopedic operations.
- Procedures were conducted in conventional or ultraclean air environments.
- Various combinations of staff attire (cotton, Ventile, laminate, polypropylene) and patient drapes (cotton, laminate) were tested.
Main Results:
- A combination of polypropylene coveralls and laminate theatre gowns drastically reduced bacterial fallout, matching ultraclean air levels even in conventional theaters.
- This combination outperformed Ventile gowns with laminate drapes in ultraclean air settings.
- The lowest wound site contamination was achieved with laminate gowns and laminate drapes within an ultraclean air environment.
Conclusions:
- Advanced surgical attire, particularly laminate gowns and coveralls, is highly effective in controlling bacterial contamination.
- The choice of surgical attire can significantly impact microbial shedding, regardless of the ventilation system.
- Implementing optimal combinations of attire and environmental controls is essential for minimizing surgical site infections.