Patient warming systems are used routinely to prevent hypothermia under anaesthetic, the benefits of which have been clearly shown in the anaesthetic literature. We were concerned that since these systems take ‘dirty’ air from floor level and distribute it over the patient, bacterial counts could be increased. Also, airflow under the blanket itself could disturb the patients’ own skin cells and thereby influence bacterial counts. With slit air sampling we analysed air quality at the simulated operative site by passing a known volume of air over an agar plate (tryptone glucose yeast). Using probability curves we were able to calculate the volume of air required to detect 1 colony forming unit (CFU) per m³ with 97% confidence. All tests were performed in an ultra clean air laminar flow theatre. We assessed the effect of varying degrees of skin shedding under the warming blanket using volunteer patients with Psoriasis. We also simulated activity outside the lamina flow to determine whether counts on the table were influenced. No colonies were grown in any of the study groups. Plates exposed outside the laminar flow area at floor level showed a relatively high level of contamination. We therefore conclude that the WarmTouch warming system does not influence bacterial counts at the operative site in ultraclean air ventilated theatres

Aims

Hand trauma, consisting of injuries to both the hand and the wrist, are a common injury seen worldwide. The global age-standardized incidence of hand trauma exceeds 179 per 100,000. Hand trauma may require surgical management and therefore result in significant costs to both healthcare systems and society. Surgical site infections (SSIs) are common following all surgical interventions, and within hand surgery the risk of SSI is at least 5%. SSI following hand trauma surgery results in significant costs to healthcare systems with estimations of over £450 per patient. The World Health Organization (WHO) have produced international guidelines to help prevent SSIs. However, it is unclear what variability exists in the adherence to these guidelines within hand trauma. The aim is to assess compliance to the WHO global guidelines in prevention of SSI in hand trauma.

Aims

Tissue adhesives (TAs) are a commonly used adjunct to traditional surgical wound closures. However, TAs must be allowed to dry before application of a surgical dressing, increasing operating time and reducing intraoperative efficiency. The goal of this study is to identify a practical method for decreasing the curing time for TAs.

Aims

Transfusion after primary total hip arthroplasty (THA) has become rare, and identification of causative factors allows preventive measures. The aim of this study was to determine patient-specific factors that increase the risk of needing a blood transfusion.