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Journal of Bone and Joint Surgery - British Volume, Vol 85-B, Issue 4, 490-494.
doi: 10.1302/0301-620X.85B4.13363  
Copyright © 2003 by British Editorial Society of Bone and Joint Surgery
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Body-exhaust suit versus occlusive clothing

A RANDOMISED, PROSPECTIVE TRIAL USING AIR AND WOUND BACTERIAL COUNTS

J. Der Tavitian, FRCS Ed (Trauma & Orth), Specialist Registrar in Orthopaedic Surgery1; S. M. Ong, FRCS, Research Fellow in Orthopaedic Surgery1; N. A. Taub, MSC, Lecturer in Medical Statistics2; and G. J. S. Taylor, FRCS Orth, Consultant Orthopaedic Surgeon1

1 Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK.
2 Department of Epidemiology and Public Health, University of Leicester, 22 to 28 Princess Road West, Leicester LE1 6TP, UK.

Correspondence should be sent to Mr J. Der Tavitian at 3 Woodbank, Glen Parva, Leicester LE2 9QP, UK.

We randomly allocated 50 total knee replacements to scrub teams wearing body-exhaust suits (BES) or Rotecno occlusive clothing. The effectiveness of the clothing was assessed using air and wound bacterial counts.

Bacteria were recovered from 62% of wounds (64% BES, 60% Rotecno). The mean air count was 0.5 CFU/ m3 with BES and 1.0 CFU/m3 with Rotecno (p = 0.014). The mean wound counts were 14 bacteria/wound with BES and eight bacteria/wound with Rotecno (p = 0.171). There was no correlation between the air and wound counts (r = –0.011, Spearman’s).

The higher air counts suggest that Rotecno occlusive clothing is less effective than BES, but wounds were equally contaminated with both types of clothing suggesting that at very low levels of air contamination the contribution of bacteria to the wound from the air is irrelevant. Even doubling the air counts from 0.5 to 1.0 CFU/m3 had no detectable effect on the wound.

This allows a reassessment to be made of other sources of contamination the effect of which would previously have been overwhelmed by contamination from air.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General