A study of the wound environment during total hip arthroplasty.

Two hundred and seventeen total hip replacements were performed during a trial designed to assess the influence of a surgical isolator upon postoperative wound infection. The trial was controlled by performing 108 of the replacements in a standard plenum-ventilated theatre with twenty air changes/hr, which also housed the isolator procedures. Comparative postoperative wound infection rates were 6·4% for the isolator patients and 4·6% for those operated on in the plenum-ventilated theatre. There was intraoperative wound contamination in both groups of patients and, although the isolator reduced wound contamination at operation, this bore no relationship to eventual wound sepsis.