Clean Air Operating Environment and Superficial Infection

  • R. A. Elson
Conference paper

Abstract

It is redundant to affirm that for orthopedic operations, especially total joint replacements, clean air is a mandatory requirement. The problem of wound pollution, however, has not yet been solved. I remember conversations with Sir John Charnley in which he expressed optimism that one day we would be able to pursue long surgical procedures with complete confidence that infection would never occur. However, even in one of his early papers (Charnley and Dandy, 1974) it was clear that despite a marked fall in the incidence of deep infection to 0.5%, superficial infection continued to occur in 7% of patients -- a serious and worrisome problem. At that time, many bacteriologists and surgeons remained sceptical as to the need for clean air and to the contention that so-called “nonpathogenic” organisms were significant; the succeeding ten years have amply substantiated both points. The problem of superficial infection remains, however, with its potential to cause more serious deep infection. As bacteriologists have become more aware of the pathogenicity of low grade organisms, we are in a better position to take the final steps of overcoming the problem.

Keywords

Foam Polythene Warfarin Perforation Gentamicin 

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References

  1. 1.
    Charnley, J. and Dandy, F.: Wound infection after total hip replacement performed in clean air operating room. Internal Publication No. 45. Wrightington Hospital, 1974.Google Scholar
  2. 2.
    Elson, R.A., Jephcott, A.E., McGechie, D.B., and Verettas, D.: Antibiotic-loaded acrylic cement. J. Bone Joint Surg. 59B, 200, 1977.Google Scholar
  3. 3.
    Josefsson, G., Lindberg, L., and Wiklander, B.: Systemic antibiotics and gentamicin-containing bone cement in the prophylaxis of postoperative infections in total hip arthroplasty. Clin. Orthop. 159, 194, 1981.PubMedGoogle Scholar
  4. 4.
    Lidwell, O.M., Lowbury, E.J., Whyte, W., Blowers, R., Stanley, S.J., and Lowe, D.: Effect of ultraclean air in operating rooms in deep sepsis in the joint after total hip or total knee replacement: a randomized study. Brit. med. J. 285, 10, 1982.CrossRefGoogle Scholar
  5. 5.
    Lidwell, O.M., Lowbury, E.J.L., Whyte, W., Blowers, R., Stanley, S.J., and Lowe, D.: Bacteria isolated from deep joint sepsis after operation for total hip or knee replacements and the sources of infection with Staph. aureus. J. Hosp. Infect. 4, 19, 1983a.CrossRefGoogle Scholar
  6. 6.
    Lidwell, O.M., Lowbury, E.J.L., Whyte, W., Blowers, R., Stanley, S.J., and Lowe, D.: Airborne contamination of wounds in joint replacement operations: the relationship to sepsis rates. J. Hosp. Infect. 4, 111, 1983b.PubMedCrossRefGoogle Scholar
  7. 7.
    Surin, V.V., Sundholm, K., and Backmann, L.: Infection after total hip replacement. J. Bone Joint Surg. 65B, 412, 1983.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • R. A. Elson

There are no affiliations available

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