Sacred rituals in the operating theatre: summarising the science

Respiratory and facial protection: a critical review of recent literature

Infectious micro-organisms may be transmitted by a variety of routes. This is dependent on the particular pathogen and includes bloodborne, droplet, airborne, and contact transmission. Some micro-organisms are spread by more than one route. Respiratory and facial protection is required for those organisms which are usually transmitted via the droplet and/or airborne routes or when airborne particles have been created during 'aerosol-generating procedures'. This article presents a critical review of the recently published literature in this area that was undertaken by Health Protection Scotland and the Healthcare Infection Society and which informed the development of guidance on the use of respiratory and facial protection equipment by healthcare workers.

Comparison of the efficiency of nail pick and brush used for nail cleaning during surgical scrub on reducing bacterial counts

BACKGROUND

Although the surgical scrub is a mandatory and routine procedure, there is no standard recommendation for nail cleaning during the scrub. This study compared the efficacy of nail picks and brushes used for nail cleaning during the surgical scrub in reducing bacterial counts.

METHODS

Sixty circulatory nurses were included in the survey. The nurses were randomized to undertake 1 of 3 surgical hand scrub protocols: using surgical scrub alone (control group), using a nail pick during the surgical scrub, or using a brush during the surgical scrub. Bacterial counts were measured on the dominant hand immediately before the scrub and 1 hour after the scrub using the glove juice method.

RESULTS

The bacterial counts at 1 hour after the surgical scrub were lower in the control group than in the 2 intervention groups, and there was no significant difference between the 2 intervention groups (F = 2.063; P = .136; P > .05).

CONCLUSION

Using nail picks and brushes on nails during the surgical scrub does not provide additional decontamination.

Potential for infection in orthopaedic practice due to individually packaged screws

The use of implants is widespread in orthopaedic practice. In recent times screws and plates have increasingly been supplied individually pre-packaged. We hypothesised that there is a potential for an increased risk of infection associated with the practice of using individually packaged screws. In this study an attempt was made to recreate as closely as possible the standard practice of opening screw packets in the operating theatre. The exterior of 50 screw packets was cultured. The outer screw packets were then opened over a draped instrument table above a petri dish. As a control, petri dishes were left open to the air in the same theatre environment. The packet exteriors grew cultures of organisms in 24/50 cases. The act of opening the packets yielded a growth in 7/50 cases. There was no growth on the control petri dishes. The significance of the result and potential solutions are discussed.