Clothing in laminar-flow operating theatres. 1996

M J Hubble, and A E Weale, and J V Perez, and K E Bowker, and A P MacGowan, and G C Bannister
Departments of Orthopaedics, Southmead Hospital, Westbury-on-Trym, Bristol, UK.

Bacterial shedding, wound contamination and clinical-infection rates in clean wounds are influenced by operating-theatre dress. The aim of this study was to clarify the relative contribution of hats, masks and clothing to the control of wound contamination in both ultraclean (enclosed vertical laminar-flow) and conventional (plenum ventilated) airflow theatres. Personnel wore varying combinations of dress in both types of theatre. Colony forming units (cfus) were measured on settle plates at head and waist height, and in the air by a centrifugal air sampler. Bacterial counts in conventional theatres were consistently high and were not significantly influenced by theatre dress. There was a 22-fold increase in cfus on settle plates at waist height when neither hat nor mask were worn, a 15-fold increase when a hat but no mask was worn and a fourfold increase with a mask but no hat in vertical laminar airflow enclosures, although air sample counts remained low. When balloon-cotton clothing was worn, rather than cuffed polyester with microfilament barrier-fabric gowns, cfu counts rose by a factor of six. The bacterial inoculum in conventionally ventilated theatres, or in ultraclean theatres if hat or mask are omitted or balloon-cotton clothing worn, is theoretically sufficient to infect a prosthetic arthroplasty. Theatre-air sampling alone does not reflect local contamination when a surgeon stands over a wound in a vertical laminar-flow enclosure, and both hats and masks are an important part of dress in such environments.

UI MeSH Term Description Entries
D008397 Masks Devices that cover the nose and mouth to maintain aseptic conditions often for the prevention of the spread of infections (e.g. COVID19) or to administer inhaled anesthetics or other gases. Mask
D009873 Operating Rooms Facilities equipped for performing surgery. Operating Room,Room, Operating,Rooms, Operating
D010564 Personnel, Hospital The individuals employed by the hospital. Hospital Personnel
D011481 Protective Clothing Clothing designed to protect the individual against possible exposure to known hazards. Clothing, Protective
D004780 Environment, Controlled A state in which the environs of hospitals, laboratories, domestic and animal housing, work places, spacecraft, and other surroundings are under technological control with regard to air conditioning, heating, lighting, humidity, ventilation, and other ambient features. The concept includes control of atmospheric composition. (From Jane's Aerospace Dictionary, 3d ed) Clean Rooms,Laminar Air-Flow Areas,Controlled Environment,Area, Laminar Air-Flow,Clean Room,Controlled Environments,Environments, Controlled,Laminar Air Flow Areas,Laminar Air-Flow Area,Room, Clean
D004784 Environmental Monitoring The monitoring of the level of toxins, chemical pollutants, microbial contaminants, or other harmful substances in the environment (soil, air, and water), workplace, or in the bodies of people and animals present in that environment. Monitoring, Environmental,Environmental Surveillance,Surveillance, Environmental
D006260 Head Protective Devices Personal devices for protection of heads from impact, penetration from falling and flying objects, and from limited electric shock and burn. Helmets,Device, Head Protective,Devices, Head Protective,Head Protective Device,Helmet,Protective Device, Head,Protective Devices, Head
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000391 Air Microbiology The presence of bacteria, viruses, and fungi in the air. This term is not restricted to pathogenic organisms. Microbiology, Air
D013530 Surgical Wound Infection Infection occurring at the site of a surgical incision. Postoperative Wound Infection,Infection, Postoperative Wound,Infection, Surgical Wound,Surgical Site Infection,Wound Infection, Postoperative,Wound Infection, Surgical,Infection, Surgical Site,Infections, Postoperative Wound,Infections, Surgical Site,Infections, Surgical Wound,Postoperative Wound Infections,Surgical Site Infections,Surgical Wound Infections,Wound Infections, Postoperative,Wound Infections, Surgical

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