Local air blanket protection of surgical wounds to prevent airborne contamination
It is well established that surgical wounds can be contaminated by airborne bacteria. That these airborne bacteria are a significant cause of postoperative wound infection, however, has not been proven. If one reviews the available literature on wound infection, he must reasonably consider that the air is only one of many possible modes of surgical contamination.
Charnley’s infection rate in total hip replacement surgery has decreased dramatically in recent years.1 He attributes this to his clean room facility. One cannot help but feel that the same effect may have come as a result of his increased experience with the procedure and, in part, to his elaborate preoperative preparation of the patient. Series of cases presently being gathered in the United States already show that a super clean ordinary operating room in which the surgeons follow a rigid aseptic technique and in which modifications to present air filtration systems are made can result in an infection rate for total hip replacement as satisfactory as Charnley’s.2 These are relatively early studies, and with the well-known delayed onset of infection in total hip replacement surgery, the figures may not stand the test of time. If one approaches the problems of surgical wound contamination with these thoughts in mind and realizes that the air is only one mode of bacterial transport, then a rational program to eliminate these factors can be considered.
Bacteria range in size from 0.3μ to over 10μ. Bacteria in air will usually not appear singly but rather in droplets in. . .