Sterile Parts of Operating Gown during Lower Limb Joint Replacement Surgery

The prevention of surgical site infection is one of the most concerning issues in operating rooms. Surgicalgowns are worn as one of the intraoperative strategies for infection prevention. The present study investigated whetherthe gowns remained sterile during the surgical procedure. Furthermore, this study examined which parts of the surgicalgown were more prone to contamination. The sterility of the gowns was investigated during eight total joint arthroplasties all of which were performedby four surgeons. The samples were taken from the arms and frontal part of the sterile gowns pre- and postoperatively.In the anterior surface of the gown, the sampling was initiated at a strip with 50 cm height from the ground followedby the strips with 15 cm distances from caudal to cephalad. Furthermore, the frontal part of the gown was dividedinto three parts in relation to the operating room table. Finally, the contamination rate was evaluated in each part. Asemiquantitative method was used for the analysis of bacterial culture. Before the operation, there were four samples tested positive for bacterial culture (1.06%). All of these sampleswere taken from the most proximal strip near the neckline. After the surgery, the rate of contamination in the strips onthe frontal part of the gown was reported as 3.1% to 53%. Based on the operating table, the contamination rate was35.9%, 8.9%, and 47.3% in the distal, middle, and proximal parts of the gown, respectively. The contamination rate atthe elbow crease was 23%, and at 5 and 10 cm above the creases were 24% and 36%, respectively. The high rate of gown contamination during the operation is concerning. However, part of the gown thatwas in contact with the operating room table remained clean most of the time. More safe strategies should be used forinfection prevention in operating rooms.Level of evidence: IV