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Article: The effect of the surgical helmet system on intraoperative contamination in arthroplasty surgery

TitleThe effect of the surgical helmet system on intraoperative contamination in arthroplasty surgery
Other Titlesa fluorescent quantitative simulation
Authors
KeywordsArthroplasty
Body exhaust system
Glove-gown interface
Periprosthetic joint infection
Quantitative simulation
Surgical helmet system
Issue Date13-Nov-2023
PublisherBritish Editorial Society of Bone and Joint Surgery
Citation
Bone & Joint Open, 2023, v. 4, n. 11, p. 859-864 How to Cite?
Abstract

Aims: The surgical helmet system (SHS) was developed to reduce the risk of periprosthetic joint infection (PJI), but the evidence is contradictory, with some studies suggesting an increased risk of PJI due to potential leakage through the glove-gown interface (GGI) caused by its positive pressure. We assumed that SHS and glove exchange had an impact on the leakage via GGI.

Methods: There were 404 arthroplasty simulations with fluorescent gel, in which SHS was used (H+) or not (H-), and GGI was sealed (S+) or not (S-), divided into four groups: H+S+, H+S-, H-S+, and H-S-, varying by exposure duration (15 to 60 minutes) and frequency of glove exchanges (0 to 6 times). The intensity of fluorescent leakage through GGI was quantified automatically with an image analysis software. The effect of the above factors on fluorescent leakage via GGI were compared and analyzed.

Results: The leakage intensity increased with exposure duration and frequency of glove exchanges in all groups. When SHS was used and GGI was not sealed (H+S-), the leakage intensity via GGI had the fastest increase, consistently higher than other groups (H+S+, H-S+ and H-S-) after 30 minutes (p < 0.05) and when there were more than four instances of glove exchange (p < 0.05). Additionally, the leakage was strongly correlated with the duration of exposure (rs = 0.8379; p < 0.050) and the frequency of glove exchange (rs = 0.8198; p < 0.050) in H+S-. The correlations with duration and frequency turned weak when SHS was not used (H-) or GGI was sealed off (S+).

Conclusion: Due to personal protection, SHS is recommended in arthroplasties. Meanwhile, it is strongly recommended to seal the GGI of the inner gloves and exchange the outer gloves hourly to reduce the risk of contamination from SHS.


Persistent Identifierhttp://hdl.handle.net/10722/340776
ISSN
2023 Impact Factor: 2.8
2023 SCImago Journal Rankings: 1.414
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChen, Hongtai-
dc.contributor.authorChan, Vincent W K-
dc.contributor.authorYan, Chun H-
dc.contributor.authorFu, Henry-
dc.contributor.authorChan, Ping-Keung-
dc.contributor.authorChiu, KwongYuen-
dc.date.accessioned2024-03-11T10:47:01Z-
dc.date.available2024-03-11T10:47:01Z-
dc.date.issued2023-11-13-
dc.identifier.citationBone & Joint Open, 2023, v. 4, n. 11, p. 859-864-
dc.identifier.issn2633-1462-
dc.identifier.urihttp://hdl.handle.net/10722/340776-
dc.description.abstract<div><p><strong>Aims: </strong> The surgical helmet system (SHS) was developed to reduce the risk of periprosthetic joint infection (PJI), but the evidence is contradictory, with some studies suggesting an increased risk of PJI due to potential leakage through the glove-gown interface (GGI) caused by its positive pressure. We assumed that SHS and glove exchange had an impact on the leakage via GGI.</p><p><strong>Methods: </strong> There were 404 arthroplasty simulations with fluorescent gel, in which SHS was used (H+) or not (H-), and GGI was sealed (S+) or not (S-), divided into four groups: H+S+, H+S-, H-S+, and H-S-, varying by exposure duration (15 to 60 minutes) and frequency of glove exchanges (0 to 6 times). The intensity of fluorescent leakage through GGI was quantified automatically with an image analysis software. The effect of the above factors on fluorescent leakage via GGI were compared and analyzed.</p><p><strong>Results: </strong> The leakage intensity increased with exposure duration and frequency of glove exchanges in all groups. When SHS was used and GGI was not sealed (H+S-), the leakage intensity via GGI had the fastest increase, consistently higher than other groups (H+S+, H-S+ and H-S-) after 30 minutes (p < 0.05) and when there were more than four instances of glove exchange (p < 0.05). Additionally, the leakage was strongly correlated with the duration of exposure (r<sub>s</sub> = 0.8379; p < 0.050) and the frequency of glove exchange (r<sub>s</sub> = 0.8198; p < 0.050) in H+S-. The correlations with duration and frequency turned weak when SHS was not used (H-) or GGI was sealed off (S+).</p><p><strong>Conclusion: </strong> Due to personal protection, SHS is recommended in arthroplasties. Meanwhile, it is strongly recommended to seal the GGI of the inner gloves and exchange the outer gloves hourly to reduce the risk of contamination from SHS.<br></p></div>-
dc.languageeng-
dc.publisherBritish Editorial Society of Bone and Joint Surgery-
dc.relation.ispartofBone & Joint Open-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectArthroplasty-
dc.subjectBody exhaust system-
dc.subjectGlove-gown interface-
dc.subjectPeriprosthetic joint infection-
dc.subjectQuantitative simulation-
dc.subjectSurgical helmet system-
dc.titleThe effect of the surgical helmet system on intraoperative contamination in arthroplasty surgery-
dc.title.alternativea fluorescent quantitative simulation-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1302/2633-1462.411.bjo-2023-0078.r1-
dc.identifier.scopuseid_2-s2.0-85176930194-
dc.identifier.volume4-
dc.identifier.issue11-
dc.identifier.spage859-
dc.identifier.epage864-
dc.identifier.eissn2633-1462-
dc.identifier.isiWOS:001104973600001-
dc.identifier.issnl2633-1462-

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