Abstract
Background
The purpose of this study was to evaluate a potential risk of intraoperative contamination associated with clothing systems and surgeon’s motion in total joint replacement.
Methods
The airborne particle concentrations at different locations around a single operating surgeon wearing standard surgical gown (SG) or modern “space suit” (SS) were compared. The particles in the size of ≥0.5 μm (roughly corresponding to a mean diameter of squamous epithelial cells) were counted at the following three locations: (1) ≈10 cm inferior to the wrist; (2) ≈10 cm posterior to the feet; and (3) near the chest (operative field) under condition either with or without the surgeon’s motion (stepping in place at ~1 Hz).
Results
The difference in the surgical clothing systems did not significantly affect the mean particle counts detected near the wrist and chest (p = 0.307 and 0.155, respectively). However, the particle count near the feet was 154 times higher in SS than SG (4630 ± 2795 vs. 30 ± 23 N/F3, p = 0.023). The simple stepping of the surgeon with SS increased contaminants near the chest 31 times as compared to the condition without motion (1053 ± 709 vs. 34 ± 31 N/F3, p = 0.0032). Although the particle count was less affected by the motion in SG than SS, contaminants near the chest increased ten times after the stepping in the use of SG (p = 0.032).
Conclusion
The present results suggest that the intraoperative motion of a surgeon may considerably increase airborne particle/bacterial concentration in the operative field. This can be a much higher likelihood in SS rather than SG because of air blow-off from the incorporated cooling fan.
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This article does not contain any studies with human participants or animals performed by any of the authors, and all the experimental procedures were preliminary approved by the Institutional Review Board (IRB) of our institution.
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Nakajima, D., Tateiwa, T., Masaoka, T. et al. Does modern space suit reduce intraoperative contamination in total joint replacement? An experimental study. Eur J Orthop Surg Traumatol 27, 1139–1143 (2017). https://doi.org/10.1007/s00590-016-1874-8
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DOI: https://doi.org/10.1007/s00590-016-1874-8