***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Arthroplasty surgeons are increasingly using personal protection systems with helmets . It is theoretically possible for the fans in these helmets to blow squames , sweat droplets and orobronchial fomites onto the surgical site . A controlled experiment was set up to investigate the effect of different surgical gowns on counts of airborne particles measuring ≥0.3 μm , using a h and -held particle counter . Methods The clothing that was sequentially tested included the following:1.Barrier  ® surgical gown ( single use ) made from nonwoven polypropylene ( Mölnlycke Health Care Ltd , Dunstable , UK)2.Stryker ® T5 Helmet ( reusable ) covered with a disposable Stryker ® T4/T5 urethane hood worn separate to and enclosed by the Barrier ® surgical gown both at the front and back3.Stryker ® T5 Helmet ( reusable ) worn within a disposable Stryker ® T4/T5 urethane zippered toga ( Stryker Corporation , Kalamazoo , MI , USA)Six readings were taken for each of the following three setups in a r and omised order:1.Gown : surgeon with surgical gown and face mask2.Hood : surgeon with surgical gown and hood , maximum fan speed3.Toga : surgeon with toga , maximum fan speedWilcoxon rank sum tests were applied to assess e quality of means between the three occlusive measures ( gown , hood , toga ) . P values were computed based upon one-sided tests and adjusted for multiple comparisons using the Bonferroni correction . Results The mean particle counts ( over more than 5 L of air ) for the three set-ups were : gown : 1178 ( least protective ) , hood : 328 , toga : 42 ( most protective ) . There was a significant reduction in particle counts for the toga versus gown ( p = 0.007 ) and toga versus hood ( p = 0.037 ) ; differences in particle counts were not significant between the hood and gown ( p = 0.140 ) . Conclusions The fans in the helmets do not increase contaminants by blowing particles from the head area . A significant reduction in surgeon-originated contaminants was seen with the toga compared to both the hood/gown separate ensemble and gowns alone Bacterial shedding , wound contamination and clinical -infection rates in clean wounds are influenced by operating-theatre dress . The aim of this study was to clarify the relative contribution of hats , masks and clothing to the control of wound contamination in both ultraclean ( enclosed vertical laminar-flow ) and conventional ( plenum ventilated ) airflow theatres . Personnel wore varying combinations of dress in both types of theatre . Colony forming units ( cfus ) were measured on settle plates at head and waist height , and in the air by a centrifugal air sample r. Bacterial counts in conventional theatres were consistently high and were not significantly influenced by theatre dress . There was a 22-fold increase in cfus on settle plates at waist height when neither hat nor mask were worn , a 15-fold increase when a hat but no mask was worn and a fourfold increase with a mask but no hat in vertical laminar airflow enclosures , although air sample counts remained low . When balloon-cotton clothing was worn , rather than cuffed polyester with microfilament barrier-fabric gowns , cfu counts rose by a factor of six . The bacterial inoculum in conventionally ventilated theatres , or in ultraclean theatres if hat or mask are omitted or balloon-cotton clothing worn , is theoretically sufficient to infect a prosthetic arthroplasty . Theatre-air sampling alone does not reflect local contamination when a surgeon st and s over a wound in a vertical laminar-flow enclosure , and both hats and masks are an important part of dress in such environments The influence of surgical mask usage on bacterial contamination of the operative field was studied during 30 cardiac catheterization procedures .  Mask position was varied during each procedure according to a pre design ed r and om table . The number of bacterial colonies recoverable when no mask was worn was significantly higher than that detected when a full mask was worn ( P < 0.002 ) . Shedding of Staphylococcus epidermidis was greater when no mask was worn ( mean 5.2 colonies 10 min-1 ) than shedding with full mask ( mean 2.7 colonies 10 min-1 ; P < 0.004 ) . Although mask placement below the nose was associated with higher mean colony counts than that above the nose , these differences were not statistically significant It has never been shown that wearing surgical face masks decreases postoperative wound infections . On the contrary , a 50 % decrease has been reported after omitting face masks . The present study was design ed to reveal any 30 % or greater difference in general surgery wound infection rates by using face masks or not . During 115 weeks , a total of 3,088 patients were included in the study . Weeks were denoted as “ masked ” or “ unmasked ” according to a r and om list . After 1,537 operations performed with face masks , 73 ( 4.7 % ) wound infections were recorded and , after 1,551 operations performed without face masks , 55 ( 3.5 % ) infections occurred . This difference was not statistically significant ( p > 0.05 ) and the bacterial species cultured from the wound infections did not differ in any way , which would have supported the fact that the numerical difference was a statistically “ missed ” difference . These results indicate that the use of face masks might be reconsidered . Masks may be used to protect the operating team from drops of infected blood and from airborne infections , but have not been proven to protect the patient operated by a healthy operating team . RésuméIl n'a jamais été démontré que le port d'une bavette chirurgicale diminue le nombre des infections pariétales . Au contraire , on a même rapporté une diminution de 50 % lorsqu'on ne les utilisait pas . Cette étude a été élaborée pour déceler l'influence du port de la bavette dans la réduction des taux d'infections pariétales chez l'opéré en chirurgie générale de 30 % au moins . Pendant 115 semaines , 3,088 patients ont été inclus dans cette étude . Pendant une semaine donnée , tirée au sort , les chirurgiens mettaient ou ne mettaient pas de bavette . Aprés 1,537 opérations effectuées avec bavette , on a trouvé 73 ( 4.7 % ) abcès de paroi alors qu'après 1,551 interventions sans bavette , il y a eu 55 ( 3.5 % ) infections . Cette différence n'est pas statistiquement significative ( p>0.05 ) et les cultures bactériennes à partir de la plaie opératoire ne différaient en aucune manière ce qui renforçait la conclusion que cette absence de différence statistiquement significative était réele . Ces résultats indiquent que l'utilisation de la bavette chirurgicale pourrait être remise en question . La bavette joue un rôle de protection de l'équipe chirurgicale contre les infections portées par le sang éclaboussé en salle ou contre les infections aériennes , mais son effet sur la protection du patient n'a pas été prouvé lorsque l'équipe chirurgicale elle-même est en bonne santé . ResumenNo ha sido demostrado que el uso de la máscara facial quirúrgica disminuya la tasa de infecfión postoperatoria ; por el contrario , algunos autores han informado una reducción de 50 % al omitir su uso . El présente estudio fue diseñado con el propósito de revelar una diferencia de 30 % o más en las tasas de infección de la herida en procedimientos de cirugía general con el uso y sin el uso de la máscara quirúrigica . En el curso de 115 semanas , 3,088 pacientes fueron incluídos en el estudio . Las semanas fueron design adas como “ con máscara ” o “ sin mascara , ” según la lista de r and omización . En 1,537 operaciones realizadas con máscara se registraron , 73 ( 4.7 % ) infecciones de herida y en 1,551 operaciones realizadas sin máscara se informaron 55 ( 3.5 % ) infecciones . Esta diferencia no es estadísticamente significativa ( p>0.05 ) ; las especies de bacterias aisladas de las heridas no exhibieron diferencias que puedieran hacer pensar que la diferencia númerica en favor de las operaciones sin máscara tenga importancia . Tales result ados indican que el uso de máscaras faciales puede ser reconsiderado . Las mascaras pueden ser utilizadas para proteger al personal quirúrgico de gotas de sangre infectada y de infecciones en el ambiente , pero no han demostrado que protejan al paciente que es operado por un equipo quirúrgico sano Aim : To assess whether facemask utilisation by the surgeon during cataract surgery has any effect on the bacterial load falling onto the operative site . Method : Prospect i ve r and omised masked study . Consent was obtained from 221 patients . Cases were r and omised to wearing a new mask or not wearing any mask throughout the procedure . Blood agar settle plates were placed adjacent to the patient 's head in the operative field . Duration of procedure was noted . Plates were incubated and read at 48 hours . Colony forming bacteria were counted and identified . Results : There were significantly fewer organisms cultured when the surgeon used a facemask ( p=0.0006 ) . The majority of organisms were Staphylococcus epidermidis , Bacillus spp , and Diphtheroid spp ; however Staphylococcus aureus and Pseudomonas aeruginosa were cultured on several occasions . There were no cases of infective complication . Conclusions : The main purpose of an operating mask is to prevent bacteria falling on to the operative site from the surgeon 's oropharynx or nasopharynx with the concomitant theoretical risk of infective complication . Operating masks were shown to have a significant effect on the volume of bacterial organisms falling to the operative site ; however , whether this is clinical ly significant is unknown INTRODUCTION Despite the lack of scientific evidence , surgical caps and masks are worn routinely by many physicians and nurses in the catheterisation laboratories to avoid local and generalised infections . When we changed our practice , we performed a r and omised study to assure the quality of our routine . MATERIAL AND METHODS All patients undergoing left- or right-sided cardiac catheterisation were r and omly allocated to our five laboratories . About two months after the procedure , the patients were sent a question naire concerning signs and symptoms of possible inflammation or infection after the procedure . RESULTS Of 1,034 patients , 855 ( 82.7 % ) responded to the question naire . Although 25 patients in the caps and mask group vs 19 patients in the other group ( 6.1 % vs 4.3 % , ns ) had complaints from the procedural access site in the groin , none of these could be ascribed to definite infection . DISCUSSION The use of caps and masks during percutaneous cardiac catheterisation procedures is based on the concept that the infection rate of patients is reduced . The size of the catheter used , procedure time , and the use of caps and masks  by both the surgeon and the assisting staff are discussed . CONCLUSION The routine use of caps and masks does not seem to have that much beneficial impact on the occurrence of procedure-related inflammations or infections in the cardiac catheterisation laboratory To find out if the wearing of masks influenced the number of colony forming units ( CFU ) of bacteria in the vicinity of the wound , 14 operations on the thyroid gl and were divided in 30 min periods during which personnel were r and omly allocated to wear or not to wear masks . There was at least one period with , and one without masks during each operation . Air was sample d 20 cm from the wound using a Sartorius membrane filter sample r. There were no significant differences between the groups in either numbers of CFU or species of pathogenic bacteria found The CONSORT statement is used worldwide to improve the reporting of r and omised controlled trials . Kenneth Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating A r and omly controlled trial was performed on 41 women having gynaecological surgery in which the team of surgeons and nurses wore or did not wear masks .  After major abdominal surgery , 3 of 5 patients in the unmasked group developed wound infections whereas no infection was observed in the 4 patients of the masked group . A greater number of Streptococci were also found by settle-plates on the operating table in the unmasked group . No infection was recorded after minor or vaginal surgery 
    Output:
    
From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery