CORR Insights(®): The Gown-glove Interface Is a Source of Contamination: A Comparative Study.

Abstract

T otal joint arthroplasty (TJA) infection causes severe morbidity that may result in mortality, and generates substantial costs both to the patient and the healthcare system. Early studies found that the use of negative-pressure body exhaust suits decreased the risk of deep infection following TJA [1, 4]. However, more-recent work has found an equal or higher infection rate with use of modern positive-pressure surgical helmet systems compared to conventional surgical gowns [2, 5]. It is not known why surgical helmet systems have not yielded similar decreases in infection rates as those reported with body exhaust suits. There are numerous challenges in answering this question among cases employing surgical helmet systems. These challenges include: (1) Conducting adequately powered studies of TJA infection, a rare event; and (2) using culture-positive TJA infection as a study endpoint as opposed to less-meaningful surrogates for infection.