Disposable surgical face masks for preventing surgical wound infection in clean surgery

Lipp, Allyson; Edwards, Peggy

doi:10.1590/s1516-31802012000400014

Cited by 10 publications

(5 citation statements)

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“…N95 filtering facepiece respirators (commonly known as "N95 respirators") are one type of RPD capable, with proper facial fit and usage, of reducing inhalation of airborne particulates by a factor of 10 or greater [17]. Medical masks (MM), typically called surgical masks in operative settings, are primarily devised to protect patients against infection spread by the wearer [18]. Both types of devices also serve as a physical barrier keeping sprays and splashes of infectious materials and contaminated hands and objects away from oronasal region of wearer.…”

Section: Introductionmentioning

confidence: 99%

The Respiratory Protection Effectiveness Clinical Trial (ResPECT): a cluster-randomized comparison of respirator and medical mask effectiveness against respiratory infections in healthcare personnel

et al. 2016

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BackgroundAlthough N95 filtering facepiece respirators and medical masks are commonly used for protection against respiratory infections in healthcare settings, more clinical evidence is needed to understand the optimal settings and exposure circumstances for healthcare personnel to use these devices. A lack of clinically germane research has led to equivocal, and occasionally conflicting, healthcare respiratory protection recommendations from public health organizations, professional societies, and experts.MethodsThe Respiratory Protection Effectiveness Clinical Trial (ResPECT) is a prospective comparison of respiratory protective equipment to be conducted at multiple U.S. study sites. Healthcare personnel who work in outpatient settings will be cluster-randomized to wear N95 respirators or medical masks for protection against infections during respiratory virus season. Outcome measures will include laboratory-confirmed viral respiratory infections, acute respiratory illness, and influenza-like illness. Participant exposures to patients, coworkers, and others with symptoms and signs of respiratory infection, both within and beyond the workplace, will be recorded in daily diaries. Adherence to study protocols will be monitored by the study team.DiscussionResPECT is designed to better understand the extent to which N95s and MMs reduce clinical illness among healthcare personnel. A fully successful study would produce clinically relevant results that help clinician-leaders make reasoned decisions about protection of healthcare personnel against occupationally acquired respiratory infections and prevention of spread within healthcare systems.Trial registrationThe trial is registered at clinicaltrials.gov, number NCT01249625 (11/29/2010).

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Section: Introductionmentioning

confidence: 99%

The Respiratory Protection Effectiveness Clinical Trial (ResPECT): a cluster-randomized comparison of respirator and medical mask effectiveness against respiratory infections in healthcare personnel

et al. 2016

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“…However, medical masks prevent hand-to-face contact and facial contact with large droplets and sprays. 11 Clinical evidence is inconclusive regarding whether N95 respirators are more effective than medical masks for preventing viral respiratory infection among HCP, including influenza, 3,4,6,12 accounting for differing practices 2 and positions held by clinical, 7 public health, 13,14 and regulatory organizations. 15 The objective of this study was to compare 13 the effectiveness of N95 respirators vs medical masks worn by HCP in clinical practice for prevention of workplace-acquired influenza and other viral respiratory infections in geographically diverse, high-exposure, outpatient settings.…”

mentioning

confidence: 99%

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel

Radonovich

Simberkoff

Bessesen

et al. 2019

JAMA

436

402

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IMPORTANCE Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections.OBJECTIVE To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP. DESIGN, SETTING, AND PARTICIPANTSA cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups.INTERVENTIONS Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness. MAIN OUTCOMES AND MEASURESThe primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed.RESULTS Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369 [82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, [95% CI, −0.5% to 2.5%]; P = .18) (adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, −21.9 per 1000 HCP-seasons [95% CI, −48.2 to 4.4]; P = .10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, −8.9 per 1000 HCP-seasons, [95% CI, −33.3 to 15.4]; P = .47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, −8.6 per 1000 HCP-seasons [95% CI, −28.2 to 10.9]; P = .39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, −11.3 per 1000 HCP-seasons [95% CI, −23.8 to 1.3]; P = .08). In the respirator group, 89.4% of participants reported "always" or "sometimes" wearing their assigned devices vs 90.2% in the mask group.CONCLUSIONS AND RELEVANCE Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.

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“…Highlighted high-frequency, low-cost procedures ( Table 5) include the use of bowel preparation before open general surgery 72 -74 , the use of surgical face masks 77 and the benefits of antibiotic prophylaxis for hernia repair 76 . All are reliant on aged data, with newly published evidence suggesting that these interventions are indeed low value.…”

Section: Middle and Low Impactmentioning

confidence: 99%

Savings from reducing low-value general surgical interventions

Malik

Marti

Darzi

et al. 2017

British Journal of Surgery

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Background: Finding opportunities for improving efficiency is important, given the pressure on national health budgets. Identifying and reducing low-value interventions that deliver little benefit is key. A systematic literature evaluation was done to identify low-value interventions in general surgery, with further assessment of their cost.Methods: A multiplatform method of identifying low value interventions was undertaken, including a broad literature search, a targeted database search, and opportunistic sampling. The results were then stratified by impact, assessing both frequency and cost.Results: Seventy-one low-value general surgical procedures were identified, of which five were of high frequency and high cost (highest impact), 22 were of high cost and low frequency, 23 were of low cost and high frequency, and 21 were of low cost and low frequency (lowest impact). Highest impact interventions included inguinal hernia repair in minimally symptomatic patients, inappropriate gastroscopy, interval cholecystectomy, CT to diagnose appendicitis and routine endoscopy in those who had CT-confirmed diverticulitis. Their estimated cost was €153 383 953.Conclusion: Low-value services place a burden on health budgets. Stopping only five high-volume, high-cost general surgical procedures could save the National Health Service €153 million per annum.

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Disposable surgical face masks for preventing surgical wound infection in clean surgery

Cited by 10 publications

References 1 publication

The Respiratory Protection Effectiveness Clinical Trial (ResPECT): a cluster-randomized comparison of respirator and medical mask effectiveness against respiratory infections in healthcare personnel

The Respiratory Protection Effectiveness Clinical Trial (ResPECT): a cluster-randomized comparison of respirator and medical mask effectiveness against respiratory infections in healthcare personnel

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel

Savings from reducing low-value general surgical interventions

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