The Experts below are selected from a list of 7158 Experts worldwide ranked by ideXlab platform
Mark J. Spangehl - One of the best experts on this subject based on the ideXlab platform.
-
surgeon Personal Protection an underappreciated benefit of positive pressure exhaust suits
Clinical Orthopaedics and Related Research, 2018Co-Authors: Justin L. Makovicka, Joshua S. Bingham, Karan A. Patel, Simon W. Young, Christopher P. Beauchamp, Mark J. SpangehlAbstract:BACKGROUND Positive-pressure exhaust suits cost more than standard surgical gowns, and recent evidence suggests that they do not decrease infection risk. As a result, some hospitals and surgeons have abandoned positive-pressure exhaust suits in favor of less expensive alternatives. We propose that in addition to their original purpose of decreasing infection rates, positive-pressure exhaust suits may also improve Personal Protection for the surgeon and assistants, perhaps justifying their added costs. QUESTIONS/PURPOSES (1) Do positive-pressure exhaust suits decrease exposure to particulate matter during TKA? (2) What areas covered by gowning systems are at risk of exposure to particulate matter? METHODS Three surgical gowning systems were tested: (1) surgical gown, face mask, surgical skull cap, protective eyewear; (2) surgical gown, face mask, surgical protective hood, protective eyewear; and (3) positive-pressure exhaust suit. For each procedure, a cadaver knee was injected intraarticularly and intraosseously with a 5-µm fluorescent powder mixed with water (1 g/10 mL). After gowning in the standard sterile fashion, the primary surgeon and two assistants performed two TKAs with each gowning system for a total of six TKAs. After each procedure, three independent observers graded skin exposure of each surgical participant under ultraviolet light using a standardized scale from 0 (no exposure) to 4 (gross exposure). Statistical analysis was performed using Friedman's and Nemenyi tests. The interrater reliability for the independent observers was also calculated. RESULTS The positive-pressure exhaust suits had less surgeon and assistant exposure compared with other systems (p < 0.001). The median overall exposure grade for each gowning system was 4 for System 1 (range, 3-4), 2.5 for System 2 (range, 2-3), and 0 for System 3 (range, 0-0). In pairwise comparisons between gowning systems, the positive-pressure exhaust suits had less exposure than gowning System 1 (difference of medians: 4, p < 0.001) and gowning System 2 (difference of medians: 2.5, p = 0.038). There was no difference found in exposure between Systems 1 and 2 (difference of medians: 1.5, p = 0.330). When gowning Systems 1 and 2 were removed, particulate matter was found in places that were covered such as the surgeon's beard, lips, inside the nostrils, behind the protective eyewear around the surgeon's eye, and in both eyebrows and eyelashes. CONCLUSIONS The positive-pressure exhaust suits provided greater Personal Protection with each procedure than the other two gowning systems. CLINICAL RELEVANCE With conventional gowns, particulate matter was found in the surgeon's eyelashes, under the face mask around the mouth, and inside the nostrils. Despite recent evidence that certain types of positive-pressure exhaust suits may not decrease infection, there is a clear benefit of surgeon Protection from potentially infectious and harmful patient substances. Despite their added costs, hospitals and surgeons should weigh this protective benefit when considering the use of positive-pressure exhaust suits.
-
Surgeon Personal Protection: An Underappreciated Benefit of Positive-pressure Exhaust Suits.
Clinical orthopaedics and related research, 2018Co-Authors: Justin L. Makovicka, Joshua S. Bingham, Karan A. Patel, Simon W. Young, Christopher P. Beauchamp, Mark J. SpangehlAbstract:Positive-pressure exhaust suits cost more than standard surgical gowns, and recent evidence suggests that they do not decrease infection risk. As a result, some hospitals and surgeons have abandoned positive-pressure exhaust suits in favor of less expensive alternatives. We propose that in addition to their original purpose of decreasing infection rates, positive-pressure exhaust suits may also improve Personal Protection for the surgeon and assistants, perhaps justifying their added costs. (1) Do positive-pressure exhaust suits decrease exposure to particulate matter during TKA? (2) What areas covered by gowning systems are at risk of exposure to particulate matter? Three surgical gowning systems were tested: (1) surgical gown, face mask, surgical skull cap, protective eyewear; (2) surgical gown, face mask, surgical protective hood, protective eyewear; and (3) positive-pressure exhaust suit. For each procedure, a cadaver knee was injected intraarticularly and intraosseously with a 5-µm fluorescent powder mixed with water (1 g/10 mL). After gowning in the standard sterile fashion, the primary surgeon and two assistants performed two TKAs with each gowning system for a total of six TKAs. After each procedure, three independent observers graded skin exposure of each surgical participant under ultraviolet light using a standardized scale from 0 (no exposure) to 4 (gross exposure). Statistical analysis was performed using Friedman's and Nemenyi tests. The interrater reliability for the independent observers was also calculated. The positive-pressure exhaust suits had less surgeon and assistant exposure compared with other systems (p < 0.001). The median overall exposure grade for each gowning system was 4 for System 1 (range, 3-4), 2.5 for System 2 (range, 2-3), and 0 for System 3 (range, 0-0). In pairwise comparisons between gowning systems, the positive-pressure exhaust suits had less exposure than gowning System 1 (difference of medians: 4, p < 0.001) and gowning System 2 (difference of medians: 2.5, p = 0.038). There was no difference found in exposure between Systems 1 and 2 (difference of medians: 1.5, p = 0.330). When gowning Systems 1 and 2 were removed, particulate matter was found in places that were covered such as the surgeon's beard, lips, inside the nostrils, behind the protective eyewear around the surgeon's eye, and in both eyebrows and eyelashes. The positive-pressure exhaust suits provided greater Personal Protection with each procedure than the other two gowning systems. With conventional gowns, particulate matter was found in the surgeon's eyelashes, under the face mask around the mouth, and inside the nostrils. Despite recent evidence that certain types of positive-pressure exhaust suits may not decrease infection, there is a clear benefit of surgeon Protection from potentially infectious and harmful patient substances. Despite their added costs, hospitals and surgeons should weigh this protective benefit when considering the use of positive-pressure exhaust suits.
Donald L. Jungkind - One of the best experts on this subject based on the ideXlab platform.
-
Sterility of the Personal Protection system in total joint arthroplasty.
Clinical orthopaedics and related research, 2011Co-Authors: Kenneth A. Kearns, Dan Witmer, Junaid Makda, Javad Parvizi, Donald L. JungkindAbstract:Background Bacteria shed by operating room personnel is a source of wound contamination and postoperative infections. The Personal Protection system (PPS) was designed to decrease airborne bacteria and intraoperative contamination in total joint arthroplasty.
Nicholas H. Ogden - One of the best experts on this subject based on the ideXlab platform.
-
De-escalation by Reversing the Escalation with a Stronger Synergistic Package of Contact Tracing, Quarantine, Isolation and Personal Protection: Feasibility of Preventing a COVID-19 Rebound in Ontario, Canada, as a Case Study
Biology, 2020Co-Authors: Biao Tang, Nicola Luigi Bragazzi, Zachary Mccarthy, Francesca Scarabel, Michael Glazer, Yanyu Xiao, Jane M. Heffernan, Ali Asgary, Nicholas H. OgdenAbstract:Since the beginning of the COVID-19 pandemic, most Canadian provinces have gone through four distinct phases of social distancing and enhanced testing. A transmission dynamics model fitted to the cumulative case time series data permits us to estimate the effectiveness of interventions implemented in terms of the contact rate, probability of transmission per contact, proportion of isolated contacts, and detection rate. This allows us to calculate the control reproduction number during different phases (which gradually decreased to less than one). From this, we derive the necessary conditions in terms of enhanced social distancing, Personal Protection, contact tracing, quarantine/isolation strength at each escalation phase for the disease control to avoid a rebound. From this, we quantify the conditions needed to prevent epidemic rebound during de-escalation by simply reversing the escalation process.
-
De-escalation by Reversing the Escalation with a Stronger Synergistic Package of Contact Tracing, Quarantine, Isolation and Personal Protection: Feasibility of Preventing a COVID-19 Rebound in Ontario, Canada, as a Case Study
2020Co-Authors: Biao Tang, Nicola Luigi Bragazzi, Zachary Mccarthy, Francesca Scarabel, Michael Glazer, Yanyu Xiao, Jane M. Heffernan, Ali Asgary, Nicholas H. OgdenAbstract:Since the beginning of the COVID-19 pandemic, most Canadian provinces have gone through four distinct phases of social distancing and enhanced testing. A transmission dynamics model fitted to the cumulative case time series data permits us to estimate the effectiveness of interventions implemented in terms of the contact rate, probability of transmission per contact, proportion of isolated contacts, and detection rate. This allows us to calculate the control reproduction number during different phases (which is gradually decreasing until it becomes smaller than one). Therefore, we can derive the necessary and sufficient conditions in terms of enhanced social distancing, Personal Protection, contact tracing, quarantine/isolation strength at each escalation phase for the disease control to avoid a rebound. This research aims to quantify these conditions for de-escalation by simply reversing the escalation process.
Justin L. Makovicka - One of the best experts on this subject based on the ideXlab platform.
-
surgeon Personal Protection an underappreciated benefit of positive pressure exhaust suits
Clinical Orthopaedics and Related Research, 2018Co-Authors: Justin L. Makovicka, Joshua S. Bingham, Karan A. Patel, Simon W. Young, Christopher P. Beauchamp, Mark J. SpangehlAbstract:BACKGROUND Positive-pressure exhaust suits cost more than standard surgical gowns, and recent evidence suggests that they do not decrease infection risk. As a result, some hospitals and surgeons have abandoned positive-pressure exhaust suits in favor of less expensive alternatives. We propose that in addition to their original purpose of decreasing infection rates, positive-pressure exhaust suits may also improve Personal Protection for the surgeon and assistants, perhaps justifying their added costs. QUESTIONS/PURPOSES (1) Do positive-pressure exhaust suits decrease exposure to particulate matter during TKA? (2) What areas covered by gowning systems are at risk of exposure to particulate matter? METHODS Three surgical gowning systems were tested: (1) surgical gown, face mask, surgical skull cap, protective eyewear; (2) surgical gown, face mask, surgical protective hood, protective eyewear; and (3) positive-pressure exhaust suit. For each procedure, a cadaver knee was injected intraarticularly and intraosseously with a 5-µm fluorescent powder mixed with water (1 g/10 mL). After gowning in the standard sterile fashion, the primary surgeon and two assistants performed two TKAs with each gowning system for a total of six TKAs. After each procedure, three independent observers graded skin exposure of each surgical participant under ultraviolet light using a standardized scale from 0 (no exposure) to 4 (gross exposure). Statistical analysis was performed using Friedman's and Nemenyi tests. The interrater reliability for the independent observers was also calculated. RESULTS The positive-pressure exhaust suits had less surgeon and assistant exposure compared with other systems (p < 0.001). The median overall exposure grade for each gowning system was 4 for System 1 (range, 3-4), 2.5 for System 2 (range, 2-3), and 0 for System 3 (range, 0-0). In pairwise comparisons between gowning systems, the positive-pressure exhaust suits had less exposure than gowning System 1 (difference of medians: 4, p < 0.001) and gowning System 2 (difference of medians: 2.5, p = 0.038). There was no difference found in exposure between Systems 1 and 2 (difference of medians: 1.5, p = 0.330). When gowning Systems 1 and 2 were removed, particulate matter was found in places that were covered such as the surgeon's beard, lips, inside the nostrils, behind the protective eyewear around the surgeon's eye, and in both eyebrows and eyelashes. CONCLUSIONS The positive-pressure exhaust suits provided greater Personal Protection with each procedure than the other two gowning systems. CLINICAL RELEVANCE With conventional gowns, particulate matter was found in the surgeon's eyelashes, under the face mask around the mouth, and inside the nostrils. Despite recent evidence that certain types of positive-pressure exhaust suits may not decrease infection, there is a clear benefit of surgeon Protection from potentially infectious and harmful patient substances. Despite their added costs, hospitals and surgeons should weigh this protective benefit when considering the use of positive-pressure exhaust suits.
-
Surgeon Personal Protection: An Underappreciated Benefit of Positive-pressure Exhaust Suits.
Clinical orthopaedics and related research, 2018Co-Authors: Justin L. Makovicka, Joshua S. Bingham, Karan A. Patel, Simon W. Young, Christopher P. Beauchamp, Mark J. SpangehlAbstract:Positive-pressure exhaust suits cost more than standard surgical gowns, and recent evidence suggests that they do not decrease infection risk. As a result, some hospitals and surgeons have abandoned positive-pressure exhaust suits in favor of less expensive alternatives. We propose that in addition to their original purpose of decreasing infection rates, positive-pressure exhaust suits may also improve Personal Protection for the surgeon and assistants, perhaps justifying their added costs. (1) Do positive-pressure exhaust suits decrease exposure to particulate matter during TKA? (2) What areas covered by gowning systems are at risk of exposure to particulate matter? Three surgical gowning systems were tested: (1) surgical gown, face mask, surgical skull cap, protective eyewear; (2) surgical gown, face mask, surgical protective hood, protective eyewear; and (3) positive-pressure exhaust suit. For each procedure, a cadaver knee was injected intraarticularly and intraosseously with a 5-µm fluorescent powder mixed with water (1 g/10 mL). After gowning in the standard sterile fashion, the primary surgeon and two assistants performed two TKAs with each gowning system for a total of six TKAs. After each procedure, three independent observers graded skin exposure of each surgical participant under ultraviolet light using a standardized scale from 0 (no exposure) to 4 (gross exposure). Statistical analysis was performed using Friedman's and Nemenyi tests. The interrater reliability for the independent observers was also calculated. The positive-pressure exhaust suits had less surgeon and assistant exposure compared with other systems (p < 0.001). The median overall exposure grade for each gowning system was 4 for System 1 (range, 3-4), 2.5 for System 2 (range, 2-3), and 0 for System 3 (range, 0-0). In pairwise comparisons between gowning systems, the positive-pressure exhaust suits had less exposure than gowning System 1 (difference of medians: 4, p < 0.001) and gowning System 2 (difference of medians: 2.5, p = 0.038). There was no difference found in exposure between Systems 1 and 2 (difference of medians: 1.5, p = 0.330). When gowning Systems 1 and 2 were removed, particulate matter was found in places that were covered such as the surgeon's beard, lips, inside the nostrils, behind the protective eyewear around the surgeon's eye, and in both eyebrows and eyelashes. The positive-pressure exhaust suits provided greater Personal Protection with each procedure than the other two gowning systems. With conventional gowns, particulate matter was found in the surgeon's eyelashes, under the face mask around the mouth, and inside the nostrils. Despite recent evidence that certain types of positive-pressure exhaust suits may not decrease infection, there is a clear benefit of surgeon Protection from potentially infectious and harmful patient substances. Despite their added costs, hospitals and surgeons should weigh this protective benefit when considering the use of positive-pressure exhaust suits.
Kenneth A. Kearns - One of the best experts on this subject based on the ideXlab platform.
-
Sterility of the Personal Protection system in total joint arthroplasty.
Clinical orthopaedics and related research, 2011Co-Authors: Kenneth A. Kearns, Dan Witmer, Junaid Makda, Javad Parvizi, Donald L. JungkindAbstract:Background Bacteria shed by operating room personnel is a source of wound contamination and postoperative infections. The Personal Protection system (PPS) was designed to decrease airborne bacteria and intraoperative contamination in total joint arthroplasty.