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Much of present global and international policies are based onequivocal evidence bases from laboratory studies of the filtration efficiencyof surgical face mask and of possible contaminations of the surgical arenausing settle plates. Such indirect evidence is of questionable clinicalrelevance practice.Agreed the widespread utilization of the surgical face masks inOperation Theater, the issue of wearing face mask and its association withspreading infection was positive but statistically non-significant and it surprisedme and this topic remains surprisingly under negotiation.Discussion   1.

3.2.4 Washing hands again is recommended. Once you’ve disposed of the mask safely, washyour hands once more to ensure they’re clean and didn’t get contaminated bytouching the dirty mask.b.    In a non- surgical setting where the mask could becontaminated, place the mask by itself inside a plastic bag.

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Tie the plasticbag closed and then throw the plastic bag in the garbage bin.a.     1In surgical settings there is most likely agarbage bin specifically for biohazardous items like used masks and gloves.

1.3.2.3 Dispose of your mask safely.

Surgical masks are designed to only be usedonce. Therefore after taking the mask off, placing it in the trash immediatelyis necessary. c.

   Bands: Using hands to bring the bottom elastic bandup and over head, then use hands to do the same with the top elastic band.Remove the mask from face while holding the top elastic band.b.  Ties/Straps: Using hands to untie the bottom straps first,then untie the top straps. Remove the mask while holding onto the top ties.

a.  Ear Loops: Using hands to hold the ear loops and removethem from around each ear.1.3.

2.2 Removing the mask carefully. Ingeneral, remove the mask by only touching the edges, straps, loops, ties orbands. Do not touch the front portion of the mask which may be contaminated.1.3.

2.1 Cleansing hands. Depending on what you were doing with yourhands before you remove your mask, you may need to wash your hands. Or you mayneed to remove medical gloves, wash your hands and then remove the mask.1.

3.2      TakingOff a Mask1.3.1.8  Fit the mask to your face and under your chin. Once the mask is completely secured, adjustit to ensure it covers your face and mouth, and so the bottom edge is underyour chin.

1.3.1.7  Tie the lower band of the mask if needed. If you’re using a mask with bands that tieon the top and bottom, you can now tie the bottom band around the base of yourskull.

Because adjusting the bendable nose piece can impact the fit of themask, it is best to wait until after the nose piece is in place before tyingthe bottom straps.111.3.1.6  Adjust the nose piece. Now that the surgicalmask is in place on your head and face, use your index finger and thumb topinch the bendable portion of the top edge of the ask around the bridge of yournose.

c.      Bands: Some masks come with two elastic bands thatare placed over and around the back of your head (as opposed to around yourears). Hold the mask in front of your face, pull the top band over the top ofyour head and place it around the crown of your head. Then pull the bottom bandover the top of your head and place it at the base of your skull.

Mold or pinchthe stiff edge to the shape of your nose.b.     Ties or Straps: Some masks comes with pieces of fabric thatare tied around the back of your head. Most masks with ties come with an upperand lower ties or straps. Pick up the mask by the upper ties, place the tiesaround the back of your head and attach them together with a bow.a.

     Ear Loops: Some masks have two ear loops on eitherside of the mask. These loops are normally made of an elastic material so theycan be stretched. Pick up this type of mask by the loops, put one loop aroundone ear and then put the other loop around your other ear.

1.3.1.5  Placing the mask on your face.

There are many types of surgical masksavailable, each with different methods of attaching the mask to your head.91.3.1.4  Ensure the proper side of the mask facesoutwards. The inside ofmost surgical masks is white in color, while the outside has a color of somesort.

Before applying the mask to your face, make sure the white side of themask is facing towards your face.1.3.1.

3  Orient the top of the mask properly. In order for the mask to fit as close toyour skin as possible, the top portion of the mask will have a bendable, butstiff, edge that can be molded around your nose. Ensure this bendable side isfacing upwards before applying the mask to your face.1.3.

1.2  Check the Surgical mask for defects. Once you’ve taken a new (unused) surgical maskfrom the box, check it to ensure it doesn’t contain any defects, holes or tearsin the material. If the mask has defects, holes or tears, throw it away andselect another new (unused) mask from the box.b.    Always use aclean paper towel to dry your hands, and then place that paper towel into atrash bin.

Before you throw it away you may want to use that paper towel toopen/close a door after you’ve washed your handsa.     Once you’veapplied soap to your wet hands, you should rub your hands together to wash themfor at least 20 seconds before rinsing them off(“CleanYour Hands – Communicable Disease Control and Prevention, San FranciscoDepartment of Public Health,” n.d.).

1.3.1.1  Clean your hands. Beforetouching a clean surgical mask, wash your hand thoroughly with both soap andwater(“How toput on a Face Mask – Communicable Disease Control and Prevention, San FranciscoDepartment of Public Health,” n.d.).1.

3.1      Puttingon a Mask1.3  Howto Put on a Surgical Mask Surgical N95 Respirators must be put on andtaken off in an area outside of the contaminated area.

Putting a respirator onor taking it off even for a few seconds in a contaminated area can expose thewearer to significant levels of hazards. Each facility has a different policyon disposal of the respirator depending on use conditions and the type of hazardthat these products are being used to protect against(“moldex,” n.d.).1.2.

2.3  Length Of WearSurgical N95 Respirators are designed to sealthe respirator to the face and pass a fit test. Under Respiratory ProtectionStandard, if the wearer is unable to obtain a proper fit, they must not enterthe contaminated area. A properly fit tested N95 Respirator will greatly reducethe number of small particles which will enter the wearer’s respiratory systemas compared to a surgical. The extent of that reduction is a function of thefit of the mask, its filtration efficiency level (with Respirators availablefrom 95% to 99.

97% filter efficiency)(“moldex,” n.d.).1.2.2.

2  Fitd.    Have specific use instructions, warnings andlimitations for use in healthcare environments.c.     Require fit-testing and must be adjusted to theface to provide the intended effectiveness.b.    Form a tight seal over the mouth and nose.a.     Surgical N95 respirators are designed to reducebut cannot eliminate the wearer’s exposure to airborne biological contaminants.

They do not eliminate the risk of illness, disease, or death.1.2.2.1  Purpose of use1.2.2      SurgicalN95 RespiratorsA mask wet with exhaled moisture has increased resistance toairflow, is less efficient at filtering bacteria and has increased venting.Current recommendations are that a new surgical mask is used for each surgicalcase and that they should be changed when(Lipp, n.

d.). Some respirators are claimed to be effective for a full shift,although storage to avoid contamination between cases would be problematic.1.

2.1.3  Length Of WearThe most important thing about the surgical masks is that they arenot designed to pass a fit test. Their purpose is to help protect theenvironment and other nearby persons from the wearer’s contaminants. When mostsurgical masks are worn, they will have gaps around the edges that allow manysmall particles to enter the respiratory system of the wearer. Even tighterfitting surgical masks will have some gaps that allow many small particles toenter the wearer’s respiratory system.1.2.

1.2  Fit d.     Its help prevent exposure of patients to thewearer’s saliva and respiratory secretions.c.      Are designed to cover the mouth and noseloosely, but are not sized for individual fit.

b.     Its help protect against exposure tomicroorganisms, body fluids, and large particles in the air.a.      Its include masks labeled as surgical, laser,isolation, dental, or medical procedure masks.1.2.1.1  Purpose of Use1.

2.1      SurgicalMasks    e.      Not be worn loosely around the neck, but beremoved and discarded as soon as practicable after use.d.     Be removed by untying and handled only by theties and never by the face covering part which may be heavily contaminated withthe microorganisms.c.      Not be touched by hand while being worn.

b.     Be used only once and changed when moist orgrossly contaminated.a.      Be fitted according to the manufacturer’sinstructions.The type of mask best suited to aparticular situation depends on the body substances likely to be encounteredand the nature of the activity.

Wearing of masks during routine ward proceduressuch as wound dressing or invasive medical procedures is not necessary. Masksin conjunction with eyewear should be worn during procedures that are likely togenerate aerosols or splashes of blood and/or body fluids to preventcontamination of mucous membranes of the mouth, nose, and eyes. It is importantto note that surgical masks provide protection against droplets nuclei. Becausethey are not designed to provide a close facial seal which is essential forprotection of airborne particles of <5?. In addition they should also bechanged as soon as practicably possible if they become visibly contaminated ormoist(Damani and Damani, 2012).1.

2  Typesof Surgical Masks Operating techniques and clinicalsituations that create aerosolized hazardous agents pose a potential threat tostaff. To evaluate mask effectiveness against aerosolized hazardous agents, tested eight typesof masks for aerosol particle penetration either through the mask or via aleak. In this laboratory study, they predict that the surgical masks provideinsufficient protection against potentially hazardous submicron-sized particles(September and 2003, n.

d.). The need to protect staff from contaminationby patients has become more urgent.

A recent study of 40 hospital staff whocontracted severe acute respiratory syndrome in Hong Kong found that all staffhad worn masks with a minimum bacterial filtration efficiency of 95 per cent.Staff did not use respirators and only 28 per cent had used eye shields. Theimplication from these findings is that surgical masks alone do not providesufficient protection against severe acute respiratory syndrome (Riley et al., 2003).

Protection for the Wearer Specialist surgery, such astransplantation and orthopedics, is often cited as a special case, wherewearing a mask to protect the patient is crucial to avoid deep infection. Inthese types of surgery, infection is more likely to have grave repercussions.The risks of not wearing a mask are arguably too great. Crucially, there are norandomized controlled trials that demonstrate a link between wearing and notwearing a mask and surgical site infection in these specialisms. The majorevidence in this field is based on contamination. The argument for wearing asurgical mask in this sphere of surgery could more rationally be based on staffprotection, as sub-micron-sized particles are likely to be present.

Althoughmedical staff often wear face masks in the operation theatre, there is littleclinical evidence to suggest that this practice influences wound contamination.A large, controlled prospective trial reported that the use of face masks bythe surgical team standing over the sterile field did not affect woundinfection rates(Tunevall, 1991a). A nonrandomized study suggestedthat wound infection rates may actually increase when face masks are worn(Skinner and Sutton, 2001).

while in another study showsthree trials were included, involving a total of 2113 participants. There wasno statistically significant difference in infection rates between the maskedand unmasked group in any of the trials(Lipp and Edwards, 2012).Measuring InfectionAlwitry et al’s (2002) study oncontamination in cataract surgery maintains that masks should continue to beworn. The researchers combine the two deficits of a small sample size and extrapolationfrom contamination to infection ‘despite the unproven link between bacterialload and endopthalmitis rate(Racz et al., 2017).

Surgical face masks prevent thedispersal of bacteria from the upper airway to surfaces immediately in front ofand below the face during talking. However, mask wiggling has been reported toincrease dermabrasion and bacterial contamination of surfaces immediately belowthe face. Facial hair and recent shaving may alter the quantity of particlesshed by dermabrasion when the mask is wiggled.

McLure et al (2000) found thatbacterial shedding from people with beards was increased. They suggest thatbearded males should avoid mask wiggling and recommend the removal of beards(McLure et al., 2000).Measuring Contamination Masks do not filter allparticulates from the air inhaled and exhaled by the wearer. Much of the air isdrawn in and escapes where there is least resistance to flow, usually aroundthe sides of the mask (venting). The masks do not form a complete seal againstthe face and are therefore not classed as respirators or personal protectiveequipment(September and 2003, n.

d.).A surgical face mask is correctlyworn only one way. The blue side is liquid repellant to keep fluids fromleaking through into your nasal cavity. It is worn on the outside.

The whiteside is the filter and filters both what you are inhaling and what you areexhaling. Infection control is designed to protect the patient and the wearer(“Why surgical masks have a blue and white side? | Surgery -Quora,” n.d.).The design of the surgical masksdepends on the mode; usually the masks are 3 ply/3 layers. This 3 ply materialis made up from a melt-blown material placed between non-woven fabrics. Themelt-blown material acts as the filter that stops microbes from entering orexiting the mask.

Most surgical masks feature pleats or folds. Commonly, 3pleats are used allowing the user to expand the mask so it covers the area fromthe nose to the chin. There are 3 different ways to secure the masks. The mostpopular is the ear loop, where a string like material is attached to the maskand placed behind the ears. The other is the tie-on and the head band. Thetie-on straps consist of four non-woven straps that are tied behind the head.(September and 2003, n.d.

).A facemask is a loose-fitting,disposable device that creates a physical barrier between the mouth and nose ofthe wearer and potential contaminants in the immediate environment. Facemasksare not to be shared and may be labeled as surgical, isolation, dental or medicalprocedure masks. They may come with or without a face shield(Health, n.d.).The history of the surgical maskcan be divided into three separate eras, the first being the development andtesting of the mask from 1905 to 1920, and the second being the period when theimportance of the surgical mask was stressed and new masks were developed,1920-1940. The third era is one of the unimportance of the mask, secondary tothe antibiotic age (1940)(Rockwood and O’donoghue, 1960).

1.1  Historicalbackground Literature Review  2.    To determineeffects of surgical face mask in operation theater on the infection controlafter surgical operation.

1.    To determinewhether the wearing of disposable surgical face masks by the surgical teamduring surgery has any associations with reduction of postoperative surgicalwound infection or not.Objectives To identify the effect of surgical face mask in operationtheater.Aim of study  2.    Reducing thesurgical wound infections throw wearing face mask.1.     Role of the surgical mask as an effectivemeasure in preventing surgical wound infections is questionable and warrants asystematic review.

Rationale for the Study:Surgical face masks were originallydeveloped to contain and filter droplets containing microorganisms expelledfrom the mouth and nasopharynx of healthcare workers during surgery. Thepurpose of face masks is thought to be two-fold: to prevent the passage ofgerms from the healthcare worker’s nose and mouth into the patient’s wound andto protect the medical staff’s face from sprays and splashes from the patient.Face masks are thought to make wound infections after surgery less likely.However, there are several ways in whichsurgical face masks could potentially contribute to contamination of thesurgical wound, e.g. by incorrect wear or by leaking air from the side of themask due to poor string tension(Vincent and Edwards, 2016a).

Face masks are importantcomponents of surgical attire. There is good evidence that it decreases thenumber of bacteria in the air in the operating theatre(Whalan, 2006), Effective face mask acts as aprotective shield for the wearer. Face masks protect the personnel frominhaling any potentially hazardous infective particle from entering the oral ornasal space. Face masks also prevent bacteria from dispersing in the vicinityof the operative site from the healthcare worker’s oro-pharynx or nasopharynx,which are one of the most microbial infested parts of the human body(Kelkar et al.

, 2013).Face masks are one tool utilizedfor preventing the spread of disease.  They may also be named medical,procedure, or surgical face masks.

Face masks are loose-fitting masks thatcover the nose and mouth, and have ear loops or ties or bands at the back ofthe head(“How to put on a Face Mask – Communicable Disease Control andPrevention, San Francisco Department of Public Health,” n.d.).

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