title: Contamination Relative to the Activation Timing of Filtered-Exhaust Helmets.
abstract: BACKGROUND
  Filtered-exhaust helmet systems are commonplace during total joint arthroplasty, but their ability to limit intraoperative contamination has been questioned. We hypothesized that activation of the airflow system after complete gowning would lead to decreased contamination of the surgical environment.
  
  
  METHODS
  Using a fluorescent particle model, the maximal particle spread from a filtered-exhaust helmet and contamination of the surgical environment based on timing of airflow activation through simulated surgical gowning procedures were evaluated.
  
  
  RESULTS
  Helmet airflow analysis revealed particle spread greater than 5 feet in all trials. Activation before gowning resulted in a significantly greater contamination in the control group compared with the experimental group (P = .014).
  
  
  CONCLUSIONS
  We recommend complete surgical gowning before activation of the airflow system.
authors.affiliation: Department of Orthopaedics, West Virginia University, Morgantown, West Virginia.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Hanselman
authors.affiliation: Department of Orthopaedics, West Virginia University, Morgantown, West Virginia.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Montague
authors.affiliation: Department of Orthopaedics, West Virginia University, Morgantown, West Virginia.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Murphy
authors.affiliation: Department of Orthopaedics, West Virginia University, Morgantown, West Virginia.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Dietz
mesh_terms: D004866:Equipment Contamination; D006260:Head Protective Devices; D017053:Infection Control / Q000592:standards*; D009873:Operating Rooms / Q000592:standards*; D013530:Surgical Wound Infection / Q000517:prevention & control*
keywords: arthroplasty; contamination; filtered-exhaust; space suit; ultraviolet fluorescent powder