Levels of carbon dioxide in helmet systems used during orthopaedic operations

Do 'Surgical Helmet Systems' or 'Body Exhaust Suits' Affect Contamination and Deep Infection Rates in Arthroplasty? A Systematic Review

This systematic review examined whether negative-pressure Charnley-type body exhaust suits (BES) or modern positive-pressure surgical helmet systems (SHS) reduce deep infection rates and/or contamination in arthroplasty. For deep infection, four studies (3990 patients) gave adjusted relative risk for deep infection of 0.11 (P = 0.09) against SHS. Five of 7 (71%) studies found less air contamination and 2 of 4 studies (50%) less wound contamination with BES. One of 4 (25%) found less air contamination with SHS and 0 of 1 (0%) less wound contamination. In contrast to BES, modern SHS designs were not shown to reduce contamination or deep infection during arthroplasty.

Airborne Exposure of Methyl Methacrylate During Simulated Total Hip Arthroplasty and Fabrication of Antibiotic Beads

As the use of cement remains prevalent in orthopedic surgery, so do concerns over the safety of its active ingredient, methyl methacrylate (MMA). The Occupational Health and Safety Agency (OSHA) limits the airborne exposure to 100 parts per million (ppm) averaged over an 8 hour period. We measured MMA exposure to operating room personnel during simulated total hip arthroplasty (THA), antibiotic bead fabrication and simulated spill of MMA. Cumulative and peak exposures during simulated THA and antibiotic bead fabrication did not exceed OSHA limits of 100ppm. Vacuum mixing and greater distance from the vapor source reduced measured MMA exposure. Spilled MMA led to prolonged and elevated MMA levels. MMA levels returned to a negligible level in all scenarios by 20 minutes after mixing.

Surgical helmets and SARS infection

Performance testing of two brands of surgical helmets indicated that their efficiency at in vivo filtration of sub–micrometer-sized particles is inadequate for their use as respirators. These helmets are not marketed for respiratory protection and should not be used alone for protection against severe acute respiratory syndrome when performing aerosol-generating procedures.