Surgical helmet systems in total joint arthroplasty: assessment of hood sterility and donning technique.

Autor: McAleese T; RCSI University of Medicine and Health Sciences, Dublin, D02 YN77, Ireland. timmcaleese@rcsi.ie.; Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, D24 NR04, Ireland. timmcaleese@rcsi.ie., Ó Doinn T; Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, D24 NR04, Ireland., Broderick JM; Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, D24 NR04, Ireland., Farrington R; Department of Microbiology, Tallaght University Hospital, Dublin, D24 NR04, Ireland., Prior AR; Department of Microbiology, Tallaght University Hospital, Dublin, D24 NR04, Ireland., Quinlan JF; Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, D24 NR04, Ireland.
Jazyk: angličtina
Zdroj: Arthroplasty (London, England) [Arthroplasty] 2023 Nov 15; Vol. 5 (1), pp. 53. Date of Electronic Publication: 2023 Nov 15.
DOI: 10.1186/s42836-023-00212-4
Abstrakt: Background: The incidence of prosthetic joint infection (PJI) is increasing, coincident with the rising volume of joint arthroplasty being performed. With recent controversy regarding the efficacy of surgical helmet systems (SHS) in preventing infection, the focus has turned to the correct donning techniques and usage of surgical hoods. The aim of this study was to compare the bacterial contamination of the operating surgeon's gloves after two common donning techniques of SHS hoods. We also evaluated the baseline sterility of the SHS hoods at the beginning of the procedure.
Methods: The bacterial contamination rate was quantified using colony-forming units (CFUs), with 50 trials performed per donning technique. Samples were cultured on 5% Columbia blood agar in ambient air at 37 °C for 48 h and all subsequent bacterial growth was identified using a MALDI-TOF mass spectrometer. In Group 1, the operating surgeon donned their colleague's hood. In Group 2, the operating surgeon had their hood applied by a non-scrubbed colleague. After each trial, the operating surgeon immediately inoculated their gloves onto an agar plate. The immediate sterility of 50 SHS hoods was assessed at two separate zones-the screen (Zone 1) and the neckline (Zone 2).
Results: There was no significant difference in contamination rates between the two techniques (3% vs. 2%, P = 0.99) or between right and left glove contamination rates. Immediately after donning, 6/50 (12%) of SHS hoods cultured an organism. Contamination rates at both the face shield and neckline zones were equivalent. The majority of bacteria cultured were Bacillus species.
Discussion: We found no significant difference in the operating surgeon's glove contamination using two common SHS hood-donning techniques when they were performed under laminar airflow with late fan activation. We suggest the SHS hood should not be assumed to be completely sterile and that gloves are changed if it is touched intraoperatively.
(© 2023. The Author(s).)
Databáze: MEDLINE
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