Control of contamination of the operative team in total joint arthroplasty

Prevention of Prosthetic Joint Infection: From Traditional Approaches towards Quality Improvement and Data Mining

“…Therefore, measurements contributing to a decrease in the bacterial load during a surgery are extremely worthwhile. Attempts have been made to formulate evidence-based standards for good clinical and logistic practice in orthopedic operating rooms [96][97][98][99]. Educational programs aimed at educating orthopedic surgeons (and all other operation room staff) in perioperative strategies of PJI prevention are ongoing.…”

Double gloving to reduce surgical cross-infection

“…In the single glove versus double gloving category, trials were carried out in dental surgery (Avery 1999b), obstetrics and gynaecology surgery (Doyle 1992;Kovavisarach 1998;Kovavisarach 1999;Kovavisarach 2002;Punyatanasakchai 2004;Turnquest 1996), abdominal surgery (Caillot 1999;Jensen 1997;Laine 2004b), plastic surgery (Marin Bertolin 1997), gastro-intestinal surgery (Naver 2000), general surgery (Gani 1990;Rudiman 1999;Thomas 2001;Wilson 1996), arthroscopic (Laine 2004a), orthopaedic and vascular surgery (Berridge 1998). Of the 11 trials comparing various combinations of double and triple gloves, seven were for orthopaedic surgery (Hester 1992;Louis 1998;Nicolai 1997;Sanders 1990;Sebold 1993;Sutton 1998;Tanner 2006) two were for maxillofacial surgery (Avery 1999a;Pieper 1995) one was for central venous cannulation and insertion of implantable catheters with ports (Duron 1996), one was for vascular surgery and one was for sternal wiring following cardiac surgery (Underwood 1993).…”

“…Twelve trials used Regent Biogel gloves Avery 1999a;Avery 1999b;Duron 1996;Laine 2004a;Laine 2004b;Naver 2000;Nicolai 1997;Sutton 1998;Tanner 2006;Underwood 1993) ten trials used Ansell gloves Gani 1990;Jensen 1997;Kovavisarach 1999;Kovavisarach 2002;Laine 2004a;Laine 2004b;Louis 1998;Sutton 1998), three trials used Smith and Nephew gloves (Marin Bertolin 1997;Sanders 1990;Turnquest 1996), four trials used Baxter gloves (Caillot 1999;Hester 1992;Louis 1998;Pieper 1995), one trial used Dial Rubber Industries gloves (Thomas 2001), one trial used Johnson and Johnson gloves (Rudiman 1999), one trial used Medigloves (Punyatanasakchai 2004), three trials used Perry orthopaedic gloves (Hester 1992;Sebold 1993;Turnquest 1996), one trial used Assistance Publique des Hopitaux de Paris gloves (Duron 1996) and another trial used Becton Dickinson gloves (Turnquest 1996). Knitted outer gloves were produced by Protek (Hester 1992;Sanders 1990), Sallis (Tanner 2006) and Dent (Underwood 1993). The glove liners were produced by Centurian (Pieper 1995), Paraderm (Sutton 1998), Repel (Pieper 1995;Sebold 1993) and Protek (Hester 1992).…”

Operative Environment

“…A relatively high rate of inner glove contamination has been identified with double‐gloving in TJA, leading to the consideration of triple‐gloving practices . Hester et al compared the rate of inner glove perforation with three different gloving protocols in TJA: latex/cloth, latex/latex, and latex/cloth/latex. They found a reduced rate of perforation when the outer glove was a cloth glove compared to a latex glove, and interposing a cloth glove between two latex gloves yielded the lowest rate of perforation.…”