CoChat
Sign Up
Cited by 118Surgical site infection preventionInfection Control in HealthcareOrthopedic Infections and Treatments

The DOI matches its Crossref record.

Importance of air quality and related factors in the prevention of infection in orthopaedic implant surgery

Gosden, P.E., MacGowan, A.P., Bannister, G.C.·1998·Journal of Hospital Infection
DOI 10.1016/s0195-6701(98)90255-9
Open this paper in CoChat — free account

Abstract

Small numbers of organisms can cause orthopaedic implant infections, which give rise to a considerable degree of morbidity and also mortality. The periprosthetic infection rates have been shown to correlate with the number of airborne bacteria within 30 cm of the wound. This is influenced by factors such as the number of operating theatre personnel, their clothing and the type of ventilation system used. Guidance on routine bacteriological monitoring of ultraclean air theatres, based on the Department of Health document Health Technical Memorandum 2025, is discussed. Factors important in minimizing the number of postoperative implant infections such as the use of ultraclean air, ultraviolet radiation, different types of surgical clothing, prophylactic antibiotics and host-related factors are also discussed. The importance of proper scientific investigation into the effectiveness of practical preventative measures in the operating room is emphasized.

Overview

Integrity signals

Registry

Crossref · 10.1016/s0195-6701(98)90255-9

Cites

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

No references could be resolved yet.

Research works printed but not linked: 59

  1. Charnley, 1969, Postoperative infection in total prosthetic replacement arthroplasty of the hip joint, Br J Surg, 56, 641, 10.1002/bjs.1800560902 · DOI
  2. Lidwell, 1982, The effect of ultraclean air in operating rooms on deep sepsis in the joint after hip or knee replacement: a randomised study, Br Med J, 285, 10, 10.1136/bmj.285.6334.10 · DOI
  3. Lidwell, 1988, Air, antibiotics and sepsis in replacement joints, J Hosp Infect, 11, 18, 10.1016/0195-6701(88)90020-5 · DOI
  4. Strachan, 1995, The prevention of orthopaedic and vascular graft infections, J Hosp Infect, 30, 54, 10.1016/0195-6701(95)90006-3 · DOI
  5. Bartzokas, 1994, Relation between mouth and haematogenous infection in total joint replacements, Br Med J, 309, 506, 10.1136/bmj.309.6953.506 · DOI
  6. Charnley, 1972, Postoperative infection after total hip replacement with special reference to air contamination in the operating room, Clin Orthop, 87, 167, 10.1097/00003086-197209000-00020 · DOI · Paper page
  7. Taylor, 1995, Wound disinfection with ultraviolet radiation, J Hosp Infect, 30, 85, 10.1016/0195-6701(95)90148-5 · DOI
  8. Lidwell, 1983, Airborne contamination of wounds in joint replacement operations: The relationship to sepsis rates, J Hosp Infect, 4, 111, 10.1016/0195-6701(83)90041-5 · DOI
  9. Johnson, 1986, The outcome of infected arthroplasty of the knee, J Bone Joint Surg, 68B, 289, 10.1302/0301-620X.68B2.3958017 · DOI
  10. Berry, 1991, The use of bone allografts in two stage reconstruction after failure of hip replacements due to infection, J Bone Joint Surg, 74A, 1460, 10.2106/00004623-199173100-00003 · DOI
  11. Fitzgerald, 1992, Total hip arthroplasty sepsis—prevention and diagnosis in complications of total hip arthroplasty, Orthop Clin North Am, 23, 259, 10.1016/S0030-5898(20)31736-3 · DOI
  12. Malchau, 1993, Prognosis of total hip replacement in Sweden, Acta Orthop Scand, 64, 497, 10.3109/17453679308993679 · DOI
  13. Whyte, 1982, The importance of airborne bacterial contamination of wounds, J Hosp Infect, 3, 123, 10.1016/0195-6701(82)90004-4 · DOI
  14. Ayliffe, 1967, Wound infections acquired from a disperser of an unusual strain of Staphylococcus aureus, J Clin Path, 20, 195, 10.1136/jcp.20.2.195 · DOI
  15. Ahl, 1987, Air contamination during hip and knee arthroplasties. Horizontal laminar flow randomized vs conventional ventilation, Acta Orthop Scand, 66, 17, 10.3109/17453679508994632 · DOI
  16. Whyte, 1973, A bacteriological evaluation of laminar-flow systems for orthopaedic surgery, J Hyg Camb, 71, 559, 10.1017/S0022172400046544 · DOI
  17. Lidwell, 1987, Ultraclean air and antibiotics for prevention of post-operative infection. A multicentre study of 8052 joint replacement operations, Acta Orthop Scand, 58, 4, 10.3109/17453678709146334 · DOI
  18. Humphreys, 1995, Survey of operating theatres in Great Britain and Ireland, J Hosp Infect, 30, 245, 10.1016/0195-6701(95)90258-9 · DOI
  19. Holton, 1993, Commissioning operating theatres, J Hosp Infect, 23, 153, 10.1016/0195-6701(93)90019-V · DOI
  20. Whyte, 1983, Suggested bacteriological standard for air in ultraclean operating rooms, J Hosp Infect, 4, 133, 10.1016/0195-6701(83)90042-7 · DOI
  21. Fox, 1995, Theatre air sampling—ignorance is bliss!, J Hosp Infect, 30, 80, 10.1016/0195-6701(95)90256-2 · DOI
  22. Fox, 1996, Theatre air sampling—once a year is not enough, J Hosp Infect, 32, 319, 10.1016/S0195-6701(96)90042-0 · DOI
  23. Carlsson, 1986, Ultraviolet radiation and air contamination during total hip replacement, J Hosp Infect, 7, 176, 10.1016/0195-6701(86)90061-7 · DOI
  24. Golder, 1980, Ultraviolet light for the control of airborne bacteria in the operating room, Ann New York Acad Sci, 353, 271, 10.1111/j.1749-6632.1980.tb18930.x · DOI
  25. Berg, 1989, Shortwave ultraviolet radiation in operating rooms, J Bone Joint Surg, 71B, 483, 10.1302/0301-620X.71B3.2656721 · DOI
  26. Berg, 1991, Ultraviolet radiation compared to an ultraclean air enclosure: Comparison of air bacterial counts in operating rooms, J Bone Joint Surg, 73B, 811, 10.1302/0301-620X.73B5.1894672 · DOI
  27. Lowell, 1980, Ultraviolet radiation and reduction in deep wound infection following hip and knee arthroplasty, Ann New York Acad Sci, 353, 285, 10.1111/j.1749-6632.1980.tb18931.x · DOI
  28. Taylor, 1995, Wound disinfection with ultraviolet radiation, J Hosp Infect, 30, 85, 10.1016/0195-6701(95)90148-5 · DOI
  29. Hambraeus, 1988, Aerobiology in the operating room — a review, J Hosp Infect, 11, 68, 10.1016/0195-6701(88)90169-7 · DOI
  30. Noble, 1975, Dispersal of skin microorganisms, Br J Dermatol, 93, 477, 10.1111/j.1365-2133.1975.tb06527.x · DOI
  31. Whyte, 1990, An investigation of occlusive polyester surgical clothing, J Hosp Infect, 15, 363, 10.1016/0195-6701(90)90093-4 · DOI
  32. Whyte, 1976, Bacterial dispersion in relation to operating room clothing, J Hyg Lond, 76, 367, 10.1017/S0022172400055297 · DOI
  33. Hubble, 1996, Clothing in laminar-flow operating theatres, J Hosp Infect, 32, 1, 10.1016/S0195-6701(96)90159-0 · DOI
  34. Babb, 1995, Risk of airborne transmission in an operating theatre containing four ultraclean air units, J Hosp Infect, 31, 159, 10.1016/0195-6701(95)90062-4 · DOI
  35. Salvati, 1982, Infection rates after 3175 total hip and knee replacements performed with and without a horizontal unidirectional filtered air-flow system, J Bone Joint Surg Am, 64, 525, 10.2106/00004623-198264040-00007 · DOI
  36. Taylor, 1993, Infection and interposition between ultraclean air source and wound, J Bone Joint Surg Br, 75B, 503, 10.1302/0301-620X.75B3.8496233 · DOI
  37. Blomgren, 1990, Reduction of contamination at total hip replacement by special working clothes, J Bone Joint Surg Br, 72B, 985, 10.1302/0301-620X.72B6.2246302 · DOI
  38. Sanzen, 1990, Air contamination during total hip arthroplasty in an ultraclean air enclosure using different types of staff clothing, J Arthroplasty, 5, 127, 10.1016/S0883-5403(06)80231-7 · DOI
  39. Scheibel, 1991, Bacterial contamination of air and surgical wounds during joint replacement operations. Comparison of two different types of staff clothing, J Hosp Infect, 19, 167, 10.1016/0195-6701(91)90220-3 · DOI
  40. Quesnel, 1975, The efficiency of surgical masks of varying design and composition, Br J Surg, 62, 936, 10.1002/bjs.1800621203 · DOI
  41. Davis, 1991, Filtration efficiency of surgical face masks: the need for meaningful standards, Am J Infect Control, 19, 16, 10.1016/0196-6553(91)90156-7 · DOI
  42. Belkin, 1997, The evolution of the surgical mask: filtering efficiency versus effectiveness, Infect Control Hosp Epidemiol, 18, 49, 10.1086/647501 · DOI
  43. Ericson, 1973, Cloxacillin in the prophylaxis of postoperative infections of the hip, J Bone Joint Surg Am, 55, 808, 10.2106/00004623-197355040-00015 · DOI
  44. Carlsson, 1977, Prophylactic antibiotics against early and late deep infections after total hip replacements, Acta Orthop Scand, 48, 405, 10.3109/17453677708992017 · DOI
  45. Hill, 1981, Prophylactic cefazolin versus placebo in total hip replacement. Report of a multicentre double-blind trial, Lancet, 1, 795, 10.1016/S0140-6736(81)92678-7 · DOI
  46. Klenerman, 1991, Combined prophylactic effect of ultraclean air and cefuroxime for reducing infection in prosthetic surgery, Acta Orthop Belg, 57, 19
  47. Norden, 1991, Antibiotic prophylaxis in orthopaedic surgery, Rev Infect Dis, 13, S842, 10.1093/clinids/13.Supplement_10.S842 · DOI
  48. Josefsson, 1981, Systemic antibiotics and gentamicin containing bone cement in the prophylaxis infections in total hip arthroplasty, Clin Orthop, 159, 194, 10.1097/00003086-198109000-00027 · DOI
  49. Rogers, 1993, Fabrication and pharmacokinetic release profile of antibiotic impregnated calcium phosphate ceramic: in vitro study, Trans Soc Biomater, 16, 256
  50. Stratton, 1974, Implant infection in orthopaedics, Med J Austr, 2, 90, 10.5694/j.1326-5377.1974.tb93624.x · DOI
  51. Cheatle, 1991, The effect of chronic orthopaedic infection on quality of life, Orthop Clin North Am, 22, 539, 10.1016/S0030-5898(20)31682-5 · DOI
  52. An, 1996, Prevention of sepsis in total joint arthroplasty, J Hosp Infect, 33, 93, 10.1016/S0195-6701(96)90094-8 · DOI
  53. Gristina, 1984, Bacterial adherence to biomaterials: the clinical significance of its role in sepsis, Trans Soc Biomater, 7, 175
  54. Elson, 1977, Bacterial infection and acrylic cement in the rat, J Bone Joint Surg, 59B, 452, 10.1302/0301-620X.59B4.925056 · DOI
  55. Taylor, 1992, Assessment of airborne bacterial contamination of clean wounds: results in a tissue model, J Hosp Infect, 22, 241, 10.1016/0195-6701(92)90048-Q · DOI
  56. Benediktsdottir, 1983, Isolation of anaerobic and aerobic bacteria from clean surgical wounds: an experimental and clinical study, J Hosp Infect, 4, 141, 10.1016/0195-6701(83)90043-9 · DOI
  57. Lilly, 1970, Effects of adhesive drapes on contamination of operation wounds, Lancet, 2, 431, 10.1016/S0140-6736(70)90053-X · DOI
  58. Hamer, 1975, Quantitative bacterial analysis of comparative wound irrigations, Ann Surg, 181, 819, 10.1097/00000658-197506000-00010 · DOI
  59. Brown, 1978, Evaluation of wound irrigation by pulsatile jet and conventional methods, Ann Surg, 2, 170, 10.1097/00000658-197802000-00013 · DOI

Cited by

Sorted by citations

Metadata

Authors
Gosden, P. E., MacGowan, A. P., & Bannister, G. C.
Affiliations
Southmead Hospital (GB)
ORCID
Venue
Journal of Hospital Infection
Publisher
Elsevier BV
Published
1998-07
Volume
39
Issue
3
Pages
173-180
ISSN
0195-6701 (ISSN-L)
DOI
10.1016/s0195-6701(98)90255-9
OpenAlex
W2096045817
Cited by
118
References
0
Citations by year
2025: 4 · 2024: 2 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 6 · 2019: 6 · 2018: 6 · 2017: 8 · 2016: 6 · 2015: 7 · 2014: 3 · 2013: 5 · 2012: 8
FWCI
0.29
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Hospital Infection (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Surgical site infection prevention
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Medicine › Surgery › Orthopedic Infections and Treatments
Keywords
orthopedic implant infection, periprosthetic joint infection, airborne bacteria, bacteriological monitoring, ultraviolet radiation, antibiotic prophylaxis, infection control
MeSH terms
Air Microbiology, Cross Infection, United Kingdom, Humans, Operating Rooms, Orthopedics, Protective Clothing, Risk Factors, Ultraviolet Therapy, Prosthesis-Related Infections, Air Pollution, Indoor, Antibiotic Prophylaxis, Prostheses and Implants

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review