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Related Experiment Videos

Clothing in laminar-flow operating theatres

M J Hubble1, A E Weale, J V Perez

  • 1Departments of Orthopaedics, Southmead Hospital, Westbury-on-Trym, Bristol, UK.

The Journal of Hospital Infection
|January 1, 1996
PubMed
Summary

Operating theatre attire significantly impacts wound contamination. Masks and hats are crucial in ultraclean environments to minimize bacterial contamination and reduce infection risk in surgical wounds.

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Area of Science:

  • Surgical Infection Prevention
  • Microbiology
  • Operating Room Environment

Background:

  • Operating theatre dress influences bacterial shedding, wound contamination, and infection rates in clean wounds.
  • Understanding the specific contributions of hats, masks, and clothing is essential for effective infection control.

Purpose of the Study:

  • To determine the relative impact of surgical hats, masks, and attire on wound contamination control.
  • To compare these effects in both ultraclean (laminar-flow) and conventional (plenum-ventilated) operating theatres.

Main Methods:

  • Colony forming units (cfus) were measured using settle plates (head and waist height) and air sampling.
  • Personnel wore various combinations of theatre dress in different airflow environments.
  • Bacterial contamination was assessed with and without hats, masks, and with different types of surgical gowns.

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Main Results:

  • Bacterial counts were high in conventional theatres, unaffected by dress.
  • In ultraclean theatres, omitting hats/masks significantly increased contamination (22-fold without both, 15-fold with hat only, 4-fold with mask only).
  • Wearing cotton gowns increased contamination sixfold compared to barrier gowns; air sampling underestimated local contamination.

Conclusions:

  • Hats and masks are vital components of surgical dress in ultraclean environments to prevent wound contamination.
  • Bacterial inoculum from inadequate dress in any theatre type can potentially infect prosthetic joints.
  • Theatre-air sampling alone is insufficient to assess contamination risk in vertical laminar-flow enclosures.