AIR CONTAMINATION DURING SKIN PREPARATION AND DRAPING IN JOINT REPLACEMENT SURGERY

Despite the use of ultraclean air, there are still cases of infection in total joint arthroplasty, One possible route by which bacteria mag: enter the wound is indirectly by contamination of instruments during skin preparation and draping, We found that bacterial air counts were 4.4 times higher during preparation and draping for hip or knee arthro plasty using an unscrubbed, ungowned leg holder than during the operat ion itself. With the leg holder scrubbed and gowned during preparation and draping, the air counts were reduced but were still 2.4 fold grea ter than intraoperatively On some occasions, the air counts during pre paration and draping exceeded the standards for ultraclean air irrespe ctive of the attire of the leg holder, We recommend that the leg is he ld by a scrubbed and gowned member of the team, More importantly, we c onsider that instrument packs should be opened only after skin prepara tion and draping have been completed.