Skip to main content
Top
Published in: Patient Safety in Surgery 1/2012

Open Access 01-12-2012 | Research

Comparison of three distinct surgical clothing systems for protection from air-borne bacteria: A prospective observational study

Authors: Ann Tammelin, Bengt Ljungqvist, Berit Reinmüller

Published in: Patient Safety in Surgery | Issue 1/2012

Login to get access

Abstract

Background

To prevent surgical site infection it is desirable to keep bacterial counts low in the operating room air during orthopaedic surgery, especially prosthetic surgery. As the air-borne bacteria are mainly derived from the skin flora of the personnel present in the operating room a reduction could be achieved by using a clothing system for staff made from a material fulfilling the requirements in the standard EN 13795. The aim of this study was to compare the protective capacity between three clothing systems made of different materials – one mixed cotton/polyester and two polyesters - which all had passed the tests according to EN 13795.

Methods

Measuring of CFU/m3 air was performed during 21 orthopaedic procedures performed in four operating rooms with turbulent, mixing ventilation with air flows of 755 – 1,050 L/s. All staff in the operating room wore clothes made from the same material during each surgical procedure.

Results

The source strength (mean value of CFU emitted from one person per second) calculated for the three garments were 4.1, 2.4 and 0.6 respectively. In an operating room with an air flow of 755 L/s both clothing systems made of polyester reduced the amount of CFU/m3 significantly compared to the clothing system made from mixed material. In an operating room with air intake of 1,050 L/s a significant reduction was only achieved with the polyester that had the lowest source strength.

Conclusions

Polyester has a better protective capacity than cotton/polyester. There is need for more discriminating tests of the protective efficacy of textile materials intended to use for operating garment.
Appendix
Available only for authorised users
Literature
1.
go back to reference Charnley J: Postoperative infection after total hip replacement with special reference to air contamination in the operating room. Clin Orthop Relat Res. 1972, 87: 167-187. 10.1097/00003086-197209000-00020.CrossRefPubMed Charnley J: Postoperative infection after total hip replacement with special reference to air contamination in the operating room. Clin Orthop Relat Res. 1972, 87: 167-187. 10.1097/00003086-197209000-00020.CrossRefPubMed
2.
go back to reference Lidwell OM: Air, antibiotics and sepsis in replacement joints. J Hosp Inf. 1988, 11 Suppl C: 18-CrossRef Lidwell OM: Air, antibiotics and sepsis in replacement joints. J Hosp Inf. 1988, 11 Suppl C: 18-CrossRef
3.
go back to reference Whyte W, Hambraeus A, Laurell G, Hoborn J: The relative importance of the routes and sources of wound contamination during general surgery II. Airborne. J Hosp Inf. 1992, 22 (1): 41-54. 10.1016/0195-6701(92)90129-A.CrossRef Whyte W, Hambraeus A, Laurell G, Hoborn J: The relative importance of the routes and sources of wound contamination during general surgery II. Airborne. J Hosp Inf. 1992, 22 (1): 41-54. 10.1016/0195-6701(92)90129-A.CrossRef
4.
go back to reference Edmiston CE, Seabrook GR, Cambria RA, Brown KR, Lewis BD, Sommers JR, Krepel CJ, Wilson PJ, Sinski S, Towne JB: Molecular epidemiology of microbial contamination in the operating room environment: Is there a risk for infection?. Surgery. 2005, 138 (4): 573-579. 10.1016/j.surg.2005.06.045.CrossRefPubMed Edmiston CE, Seabrook GR, Cambria RA, Brown KR, Lewis BD, Sommers JR, Krepel CJ, Wilson PJ, Sinski S, Towne JB: Molecular epidemiology of microbial contamination in the operating room environment: Is there a risk for infection?. Surgery. 2005, 138 (4): 573-579. 10.1016/j.surg.2005.06.045.CrossRefPubMed
5.
go back to reference Nordenadler J: Some observations on safety ventilation in operating rooms. 2010, Royal Institute of Technology, Stockholm, Building Services Engineering: PhD thesis Nordenadler J: Some observations on safety ventilation in operating rooms. 2010, Royal Institute of Technology, Stockholm, Building Services Engineering: PhD thesis
6.
go back to reference Tammelin A, Domicel P, Hambraeus A, Ståhle E: Dispersal of methicillin-resistant Staphylococcus epidermidis by staff in an operating suite for thoracic and cardiovascular surgery: relation to skin carriage and clothing. J Hosp Inf. 2000, 44: 119-126. 10.1053/jhin.1999.0665.CrossRef Tammelin A, Domicel P, Hambraeus A, Ståhle E: Dispersal of methicillin-resistant Staphylococcus epidermidis by staff in an operating suite for thoracic and cardiovascular surgery: relation to skin carriage and clothing. J Hosp Inf. 2000, 44: 119-126. 10.1053/jhin.1999.0665.CrossRef
7.
go back to reference Reinmüller B, Ljungqvist B: Evaluation of cleanroom garments in a dispersal chamber – some observations. Eur J Parent Sci. 2000, 5: 55-58. Reinmüller B, Ljungqvist B: Evaluation of cleanroom garments in a dispersal chamber – some observations. Eur J Parent Sci. 2000, 5: 55-58.
9.
go back to reference Ljungqvist B, Reinmüller B, Nordenadler J: Performance of clothing systems in the context of operating rooms: a question of patient safety. Clean Air and Containment Review. 2011, 7: 10-13. Ljungqvist B, Reinmüller B, Nordenadler J: Performance of clothing systems in the context of operating rooms: a question of patient safety. Clean Air and Containment Review. 2011, 7: 10-13.
10.
go back to reference Whyte W, Hamblen DL, Kelly IG, Hambraeus A, Laurell G: An investigation of occlusive polyester surgical clothing. J Hosp Inf. 1990, 15: 363-374. 10.1016/0195-6701(90)90093-4.CrossRef Whyte W, Hamblen DL, Kelly IG, Hambraeus A, Laurell G: An investigation of occlusive polyester surgical clothing. J Hosp Inf. 1990, 15: 363-374. 10.1016/0195-6701(90)90093-4.CrossRef
11.
go back to reference Verkkala K, Eklund A, Ojajärvi J, Tiittanen L, Hoborn J, Mäkelä P: The conventionally ventilated operating theatre and air contamination control during cardiac surgery – bacteriological and particulate matter control garment options for low level contamination. Eur J Card-thor Surg. 1998, 14: 206-210. 10.1016/S1010-7940(98)00150-X.CrossRef Verkkala K, Eklund A, Ojajärvi J, Tiittanen L, Hoborn J, Mäkelä P: The conventionally ventilated operating theatre and air contamination control during cardiac surgery – bacteriological and particulate matter control garment options for low level contamination. Eur J Card-thor Surg. 1998, 14: 206-210. 10.1016/S1010-7940(98)00150-X.CrossRef
12.
go back to reference Tammelin A, Hambraeus A, Ståhle E: Routes and sources of Staphylococcus aureus transmitted to the surgical wound during cardiothoracic surgery: Possibility of preventing wound contamination by use of special scrub suits. Inf Cont Hosp Epid. 2001, 22: 338-346. 10.1086/501910.CrossRef Tammelin A, Hambraeus A, Ståhle E: Routes and sources of Staphylococcus aureus transmitted to the surgical wound during cardiothoracic surgery: Possibility of preventing wound contamination by use of special scrub suits. Inf Cont Hosp Epid. 2001, 22: 338-346. 10.1086/501910.CrossRef
Metadata
Title
Comparison of three distinct surgical clothing systems for protection from air-borne bacteria: A prospective observational study
Authors
Ann Tammelin
Bengt Ljungqvist
Berit Reinmüller
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Patient Safety in Surgery / Issue 1/2012
Electronic ISSN: 1754-9493
DOI
https://doi.org/10.1186/1754-9493-6-23

Other articles of this Issue 1/2012

Patient Safety in Surgery 1/2012 Go to the issue