The body-exhaust system in total hip arthroplasty: A simple method to secure the body-exhaust air hose necklace using the surgeon’s own buttocks

Original Article


The closed body-exhaust ventilated system plays an important role in reducing infection rate in total hip arthroplasty. This demands a secure body-exhaust air hose. The current method of securing the air hose by tying the necklace hose ribbons around the waist often fails to hold the hose in place. This will inevitably undermine the effectiveness of the body-exhaust system. A new and simple method is described to stop the body-exhaust hose from slipping and migrating up the surgeon’s body. The surgeon’s own buttocks are used to anchor the hose ribbons in place. The new method can improve the effectiveness of the body-exhaust system and raise its potential to the maximum without causing any discomfort to the surgeon or jeopardising the sterility of the surgeon’s clothing.


Body-exhaust system Total hip arthroplasty Buttocks 

Fixation de l’habit chirurgical corps entier dans l’arthroplastie totale de hanche


L’habit chirurgical complètement fermé et ventilé joue un rôle important dans la réduction du taux d’infection en arthroplastie totale de hanche. Ceci exige des tuyaux aspirant la totalité de l’air expiré par le chirurgien. La méthode habituelle de fixation des tuyaux d’air en attachant les rubans des tuyaux autour de la taille du chirurgien n’est pas entièrement fiable. Ceci minera inévitablement l’efficacité du système d’aspiration. Une nouvelle et simple méthode est décrite pour empêcher le tuyau de glisser vers le haut du corps du chirurgien. Les propres fesses du chirurgien sont utilisées pour ancrer les rubans de tuyau en place. La nouvelle méthode peut améliorer l’efficacité du système d’aspiration et optimiser son efficacité sans causer la moindre gêne au chirurgien ou compromettre la stérilité des vêtements des chirurgiens.

Mots clés

Système d’aspiration Arthroplastie totale de hanche Fesses 


  1. 1.
    Bintcliffe IW (1983) Effects of using a Charnley-Howorth enclosure in a district general hospital. J R Soc Med. 76(4):262Google Scholar
  2. 2.
    Blomgren G, Hambraeus A, Malmborg AS (1983) The influence of the total body-exhaust suit on air and wound contamination in elective hip-operations. J Hosp Infect 4(3):257CrossRefPubMedGoogle Scholar
  3. 3.
    Charnley J (1972) Postoperative infection after total hip replacement with special reference to air contamination in the operating room. Clin Orthop 87:167PubMedGoogle Scholar
  4. 4.
    Charnley J (1973) Clean air symposium. I. Clean air in the operating room. Cleve Clin Q. 40(3):99Google Scholar
  5. 5.
    Charnley J (1974) Letter: Clean air operating room enclosures. Br Med J. 4(5938):224Google Scholar
  6. 6.
    Charnley J (1986) A clean-air operating enclosure. Clin Orthop 211:4PubMedGoogle Scholar
  7. 7.
    Der Tavitian J, Ong SM, Taub NA, Taylor GJ (2003) Body-exhaust suit versus occlusive clothing. A randomised, prospective trial using air and wound bacterial counts. J Bone Joint Surg Br 85(4):490CrossRefPubMedGoogle Scholar
  8. 8.
    Fitzgerald RH Jr, Nolan DR, Ilstrup DM, Van Scoy RE, Washington JA 2nd, Coventry MB (1977) Deep wound sepsis following total hip arthroplasty. J Bone Joint Surg Am 59(7):847PubMedGoogle Scholar
  9. 9.
    Lidwell OM, Lowbury EJ, Whyte W, Blowers R, Stanley SJ, Lowe D (1982) Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study. Br Med J (Clin Res Ed) 285(6334):10Google Scholar
  10. 10.
    Lidwell OM, Lowbury EJ, Whyte W, Blowers R, Stanley SJ, Lowe D (1983) Bacteria isolated from deep joint sepsis after operation for total hip or knee replacement and the sources of the infections with Staphylococcus aureus. J Hosp Infect 4(1):19CrossRefPubMedGoogle Scholar
  11. 11.
    Lidwell OM, Lowbury EJ, Whyte W, Blowers R, Stanley SJ, Lowe D (1983) Airborne contamination of wounds in joint replacement operations: the relationship to sepsis rates. J Hosp Infect 4(2):111CrossRefPubMedGoogle Scholar
  12. 12.
    Lidwell OM, Lowbury EJ, Whyte W, Blowers R, Stanley SJ, Lowe D (1984) Infection and sepsis after operations for total hip or knee-joint replacement: influence of ultraclean air, prophylactic antibiotics and other factors. J Hyg 93(3):505Google Scholar
  13. 13.
    Piasecki P, Gitelis S (1988) Use of a clean air system and personal exhaust suit in the orthopaedic operating room. Orthop Nurs 7(4):20Google Scholar
  14. 14.
    Ritter MA, Eitzen HE, French M (1977) Comparison of horizontal and vertical unidirectional (laminar) air-flow systems in orthopedic surgery. Clin Orthop 129:205PubMedGoogle Scholar
  15. 15.
    Ritter MA, Stringer EA (1980) Laminar air-flow versus conventional air operating systems: a seven-year patient follow-up. Clin Orthop 150:177PubMedGoogle Scholar
  16. 16.
    Rubman MH, Seigal MG, Echt AS, Burroughs GE, Lenhart SW (1998) Levels of carbon dioxide in helmet systems used during orthopaedic operations. J Bone Joint Surg Am 80:1264PubMedGoogle Scholar
  17. 17.
    Salvati EA, Robinson RP, Zeno SM, Koslin BL, Brause BD, Wilson PD Jr (1982) Infection rates after 3175 total hip and total knee replacements performed with and without a horizontal unidirectional filtered air-flow system. J Bone Joint Surg Am 64(4):525PubMedGoogle Scholar
  18. 18.
    The Charnley-Howarth ultra clean air unit (1976) Nurs Mirror Midwives J 143(16):58Google Scholar
  19. 19.
    Whyte W, Hodgson R, Tinkler J (1982) The importance of airborne bacterial contamination of wounds. J Hosp Infect 3(2):123CrossRefPubMedGoogle Scholar
  20. 20.
    Whyte W, Lidwell OM, Lowbury EJ, Blowers R (1983) Suggested bacteriological standards for air in ultraclean operating rooms. J Hosp Infect 4(2):133CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Trauma and Orthopaedic SurgeryNorthern General HospitalSheffieldUK
  2. 2.Gateford, Worksop, NottinghamshireUK

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