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To the Editor:—
Where surgeon and anesthetist once entered the operating room without modifying their persons or garb, they now don scrub suit, cap, and boots; the surgeon scrubs his hands and wears sterile gloves and gown, and everyone wears a mask. But the patient does not. With drop ether, it may be reasoned that the patient's face is covered and that the ether provides a sterile barrier. But with the use of the semi-closed method of administering anesthesia, which is employed with nitrous oxide and with halothane, the patient's exhalations escape into the room throughout the operation, and the result is as though the patient did not wear a mask. For the semi-closed method is not closed at all; it is quite open. In addition, whatever contaminants were introduced into the anesthesia machine by other patients are now freely distributed into the operating room atmosphere. It is therefore suggested
Cole F. Contamination of Operating Room by Semi-closed Anesthesia System. JAMA. 1967;202(3):245. doi:10.1001/jama.1967.03130160119037