{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:39:58Z","timestamp":1787755198079,"version":"build-2784847793"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2018,8,24]],"date-time":"2018-08-24T00:00:00Z","timestamp":1535068800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS OA"],"published-print":{"date-parts":[[2018,9,25]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Airborne microbe-carrying particles in the operating-room environment during total joint replacement are a risk factor for periprosthetic joint infection. The present study focuses on a simple environmental test, based on practices used in aseptic cleanrooms, to quantify the deposition of microbe-carrying particles onto the sterile field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Settle plates are exposed Petri dishes. A settle plate test system and sampling plan were developed from current practices used in aseptic manufacturing. A pilot study evaluated this system in an orthopaedic operating room during 22 total knee and hip arthroplasties. The microbial deposition total (MDT), expressed in colonies\/m\n                      <jats:sup>2<\/jats:sup>\n                      , is proposed as an outcome variable to report airborne sterile-field contamination as measured with settle plates. Two reference MDT levels were developed: (1) an upper limit of 450, corresponding with the ultraclean air definition of 10 colonies\/m\n                      <jats:sup>3<\/jats:sup>\n                      , and (2) a target level of 100, corresponding with 1 colony\/m\n                      <jats:sup>3<\/jats:sup>\n                      . These levels also correspond with widely used limits in aseptic cleanrooms and controlled environments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>High MDT standard deviations were noted. Ninety-one percent (95% confidence interval, 71.0% to 98.7%) of wound zone MDT levels were within the upper limit. Twenty-seven percent (95% confidence interval, 12.9% to 48.4%) of wound zone levels were within the target level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Settle plates are a feasible technique to test environmental levels of microbe-carrying particles on sterile fields during total joint replacement for scientific and environmental quality studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>This settle plate operating-room environmental test can be used in future research to validate the presence of actual ultraclean-air conditions during periprosthetic joint infection outcome studies. Surgeons also can use this test to measure intraoperative airborne microbe-carrying-particle sterile-field contamination and compare it with ultraclean-air reference levels for environmental quality-control programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.18.00001","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T18:32:03Z","timestamp":1535049123000},"page":"e0001","source":"Crossref","is-referenced-by-count":5,"title":["A Clinical Test to Measure Airborne Microbial Contamination on the Sterile Field During Total Joint Replacement"],"prefix":"10.2106","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7057-3339","authenticated-orcid":false,"given":"John H.","family":"Harp","sequence":"first","affiliation":[{"name":"Sparks Regional Medical Center, Fort Smith, Arkansas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,9,25]]},"reference":[{"issue":"2","key":"R1-20230714","first-page":"39","article-title":"Particle and microbial airborne dispersion from people","volume":"12","author":"Whyte","year":"2007","journal-title":"European Journal of Parenteral and Pharmaceutical Sciences"},{"issue":"7","key":"R3-20230714","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11999-009-0825-7","article-title":"Patients with prosthetic joint infection on IV antibiotics are at high risk for readmission","volume":"467","author":"Duggal","year":"2009","journal-title":"Clin Orthop Relat Res."},{"issue":"8","key":"R4-20230714","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.arth.2012.02.022","article-title":"Economic burden of periprosthetic joint infection in the United States","volume":"27","author":"Kurtz","year":"2012","journal-title":"J Arthroplasty"},{"issue":"8","key":"R5-20230714","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1001\/jamasurg.2017.0904","article-title":"Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention Guideline for the prevention of surgical site infection, 2017","volume":"152","author":"Berr\u00edos-Torres","year":"2017","journal-title":"JAMA Surg."},{"issue":"24","key":"R6-20230714","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.2106\/JBJS.L.00789","article-title":"Periprosthetic joint infection increases the risk of one-year mortality","volume":"95","author":"Zmistowski","year":"2013","journal-title":"J Bone Joint Surg Am."},{"issue":"11","key":"R7-20230714","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/j.ajic.2017.06.027","article-title":"Environment of care: Is it time to reassess microbial contamination of the operating room air as a risk factor for surgical site infection in total joint arthroplasty?","volume":"45","author":"Parvizi","year":"2017","journal-title":"Am J Infect Control"},{"issue":"9","key":"R8-20230714","doi-asserted-by":"crossref","first-page":"795","DOI":"10.2106\/JBJS.17.00852","article-title":"Operating-room airflow technology and infection prevention","volume":"100","author":"Weiser","year":"2018","journal-title":"J Bone Joint Surg Am."},{"key":"R9-20230714","article-title":"Health technical memorandum 03-01: specialised ventilation for healthcare premises","year":"2007","journal-title":"Part A: design and installation"},{"issue":"4","key":"R11-20230714","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1089\/sur.2017.065","article-title":"Future research opportunities in peri-prosthetic joint infection prevention","volume":"18","author":"Berbari","year":"2017","journal-title":"Surg Infect (Larchmt)"},{"key":"R12-20230714","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1002\/bjs.1800510309","article-title":"A clean air operating enclosure","volume":"51","author":"Charnley","year":"1964","journal-title":"Br J Surg"},{"issue":"87","key":"R13-20230714","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/00003086-197209000-00020","article-title":"Postoperative infection after total hip replacement with special reference to air contamination in the operating room","author":"Charnley","year":"1972","journal-title":"Clin Orthop Relat Res"},{"issue":"6334","key":"R15-20230714","first-page":"10","article-title":"Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study. 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