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Surgical Helmet Systems Were Not Associated With Lower Operative Infection Rates After Total Ankle Arthroplasty: A

Joseph A S McCahon1,2, Grant M Thomas2, Anny Hsu3

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Summary

Surgical helmet systems (SHSs) did not significantly reduce surgical site infections in total ankle arthroplasty (TAA). The study found no difference in infection rates or patient outcomes between SHS use and conventional gowning for TAA procedures.

Keywords:
prosthetic joint infectionsuperficial infectionsurgical hoodssurgical site infectiontotal ankle arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Infection Control
  • Biomedical Engineering

Background:

  • Conflicting evidence exists on the efficacy of surgical helmet systems (SHSs) in reducing joint replacement infections.
  • The impact of SHSs on infection rates specifically in total ankle arthroplasty (TAA) remains unclear.

Purpose of the Study:

  • To investigate the effectiveness of surgical helmet systems (SHSs) in reducing postoperative infection rates following total ankle arthroplasty (TAA).

Main Methods:

  • A retrospective cohort study compared infection rates in TAA patients who used SHSs versus those who used conventional gowning.
  • Data collected included demographic characteristics, infection rates (superficial and deep), patient-reported outcomes, and implant survivorship.
  • A multivariable logistic regression model controlled for factors like age, BMI, tobacco use, and diabetes.

Main Results:

  • No significant difference in overall surgical site infection (5.24% vs. 4.98%) or deep prosthetic joint infection (2.62% vs. 2.71%) was observed between the surgical helmet system (SHS) and conventional gown groups.
  • Multivariable analysis showed no association between SHS use and surgical site infections after TAA (OR=1.12, P=.710).
  • Patient-reported outcomes (FAAM, VAS, PCS) and implant survivorship were comparable between the two groups.

Conclusions:

  • Surgical helmet systems (SHSs) do not appear to offer a protective effect against surgical site infections in total ankle arthroplasty (TAA).
  • Given the potential disadvantages and costs associated with SHSs, their use in TAA should be based on individual surgeon preference.
  • Further research may be warranted to explore specific scenarios or patient populations where SHS might offer benefits.