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Large Joints Feature

Ross William Crawford, D.Phil (Oxon.) / Source: Queensland University of Technology, Wikimedia Commons, and Sasha Taylor

Space Suits in TJR: Not as Safe as You Think

Elizabeth Hofheinz, M.P.H., M.Ed. • Fri, January 5th, 2018

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New work appearing in the December 14, 2017 edition of the Journal of Arthroplasty might make surgeons question the utility of wearing space suits into operating theatre. The study is entitled, “Surgical space suits increase particle and microbiological emission rates in a simulated surgical environment.”

Ross William Crawford, D.Phil (Oxon.), professor of orthopedic research with the School of Engineering Systems at Queensland University of Technology in Australia and co-author on the research, told OTW, “This study was of interest to us because surgeons performing total joint replacement [TJR] have nearly all adopted the use of 'space suits' to both protect the surgical team from blood and other fluids and also to decrease the risk of infection.”

“No studies have ever shown the latter to be true and there is some evidence that the reverse may in fact be true.”

“Original suits were exhausted by a hose attached to the back of the surgeon. Modern systems blow hot air out of the space suit and down to the floor. The hot air can then rise into the operative field carrying particles into the surgical field.”

The authors wrote, “A comparison of emission rates between space suits and standard surgical clothing was performed in a simulated surgical environment during five separate experiments. Particle counts were analysed with two separate particle counters capable of detecting particles between 0.1 and 20 µm. An Andersen Impactor was used to sample bacteria, with culture counts performed at 24 and 48 hours.”

Dr. Crawford told OTW, “A review of the paper will show that there is much greater particle emission from space suits than without. Surgeons need to know that wearing suits may not be as benign as they believe and that the issue of increased particle emission needs to be carefully considered.”

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