Whyte W, Vesley D, Hodgson R
J Hyg (Lond). 1976 Jun;76(3):367-78. doi: 10.1017/s0022172400055297.
The effect of operating clothing on the dispersal of bacterial particles from the wearers was studied in a dispersal chamber. A comparison was made of six gowns as well as four types of trousers. The gowns were of three basic types, namely a conventional cotton type, disposable types made of non-woven fabric and those of the total-body exhaust system (Charnley type). The dispersal chamber could simulate conditions as expected both in down-flow unidirectional ultra-clean systems and in a conventional turbulent plenum-ventilated system. It was found that the disposable gowns would reduce the dispersal rate by about 30% in the simulated conventionally ventilated system and about 65% in the laminar flow system. The total-body exhaust system (Charnley) would reduce the count by 10-fold in the conventional ventilated system and by 66-fold in the laminar-flow system. The poor performance of the gowns in conventionally ventilated systems was caused by the dispersal of bacterial particles from underneath the gown (about 80%). This was not reduced by the disposable gown and only partially by the Charnley type. This small drop would be further decreased in a conventionally ventilated operating-room as only scrubbed staff would wear the gown. In order to overcome this poor performance in conventionally ventilated operating-rooms impervious trousers would be required. Four types were studied and it was demonstrated that those made either from Ventile or non-woven fabric would reduce the bacterial dispersion fourfold. As these tests had been carried out in an artificial environment checks were carried out in the unidirectional-flow operating-room during total-hip arthroplasty. This was done by comparing conventional cotton gowns with non-woven gowns and total-body exhaust gowns. The results showed good correlation between the operating room and the chamber with the non-woven fabric gown but the total-body exhaust system did not perform as well in the operating room (12-fold compared to 66-fold) the difference being possibly due to the contribution from the patient. However, as this comparison was that which would be most open to influence from other variables confidence could be placed on the chamber test results. Values were also obtained for the total number of bacterial particles dispersed by persons during a standard exercise wearing different clothing. This count was dependent on the clothing worn but a median count of between 1000 and 1500 bacterial particles/min. would be expected when conventional clothing was worn, with a range of between 300 and 19,000. This count could be reduced to about 100/min. if a total-body exhaust suit was worn (range 30-400).
在一个扩散室中研究了手术服对穿着者细菌颗粒扩散的影响。对六种手术衣和四种裤子进行了比较。手术衣有三种基本类型，即传统棉质类型、由无纺布制成的一次性类型以及全身排气系统类型（查恩利型）。该扩散室可以模拟下行单向超净系统和传统紊流静压通风系统中的预期条件。研究发现，一次性手术衣在模拟的传统通风系统中可使扩散率降低约30%，在层流系统中降低约65%。全身排气系统（查恩利型）在传统通风系统中可使细菌数量减少10倍，在层流系统中减少66倍。传统通风系统中手术衣性能不佳是由于细菌颗粒从手术衣下方扩散（约80%）所致。一次性手术衣对此并无减少作用，查恩利型仅部分减少。在传统通风的手术室中，由于只有刷手人员会穿手术衣，这种少量的扩散还会进一步降低。为了克服传统通风手术室中这种不佳的性能，需要使用不透水的裤子。研究了四种类型，结果表明由Ventile或无纺布制成的裤子可使细菌扩散减少四倍。由于这些测试是在人工环境中进行的，因此在全髋关节置换手术期间在单向流手术室中进行了检查。通过比较传统棉质手术衣、无纺布手术衣和全身排气手术衣来完成。结果表明，手术室和扩散室之间，无纺布手术衣的结果具有良好的相关性，但全身排气系统在手术室中的表现不如在扩散室中（12倍相比于66倍），差异可能是由于患者的影响。然而，由于这种比较最容易受到其他变量的影响，因此可以信赖扩散室测试结果。还获得了在标准运动中穿着不同服装的人员所扩散的细菌颗粒总数的值。这个数量取决于所穿的服装，但当穿着传统服装时，预计中位数数量在每分钟1000至1500个细菌颗粒之间，范围在300至19000个之间。如果穿着全身排气服，这个数量可以减少到约每分钟100个（范围30 - 400）。
