Second Inning: Still a Shut Out.

4) Wearing of caps and masks not necessary during cardiac catheterization

Abstract:

Although cardiac catheterization-related infections are rare, caps and masks are often worn to minimize this complication. However, documentation of the value of caps and masks for this purpose is lacking. We, therefore, prospectively evaluated the experience of 504 patients undergoing percutaneous left heart catheterization, seeking evidence of a relationship between whether caps and/or masks were worn by the operators and the incidence of infection. No infections were found in any patient, regardless of whether a cap or mask was used. Thus, we found no evidence that caps or masks need to be worn during percutaneous cardiac catheterization.

Aesop summary: Cardiac catheterization involves sticking a long catheter into your groin (or upper arm), and following the vessel to your heart. The area of skin puncture is about the size of the letter O in this sentence. Nonetheless, with no idea how many, if any, of those 504 uninfected patients had their catheterizations performed without caps and masks (perhaps none), it's equally valid to assume that the reason for no infections was caps and masks. 

This is an NFI survey. I.e.: Is it valid? No Fucking Idea. How many surgeries were performed with masks, versus without? No Fucking Idea. What in blistering Hell does any of this have to do with the efficacy of surgical masks to stop the spread of aerosolized viruses, since that was never under investigation by this study? No Fucking Idea.

Yet another worthless data point, in service of proving somebody never read a single one of these studies before burping them up as if they mattered to the topic at issue.

Four down, only 47 more piles of shit to wade through. Oh, joy.

5) Is use of surgical caps and masks obsolete during percutaneous cardiac catheterization 

Exact same pointless point, studied 13 years after the previous study, this time in Denmark. Oh, I can barely contain my anticipation at what they found!

Extract:

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 randomised study to assure the quality of our routine.

Material and methods: All patients undergoing left- or right-sided cardiac catheterisation were randomly allocated to our five laboratories. About two months after the procedure, the patients were sent a questionnaire concerning signs and symptoms of possible inflammation or infection after the procedure.

Results: Of 1,034 patients, 855 (82.7%) responded to the questionnaire. 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.

Aesop Summary: This has nothing to do with the effectiveness of masks to stop the spread of aerosolized viruses. Total waste of time. Incidentally, adds nothing to the discussion of what they were looking at, either. This is what doctors masturbating in a circle looks like.

The conclusion is the clincher: "The routine use of caps and masks does not seem to have that much beneficial impact..."

FFS, wingnuts, you just surveyed 852 people, and the best weasel word you can come up with is "seem"?!? Do they work or does it matter?? Jesus H. Christ, get enough data, and reach a fucking decision point. In Harry S Truman terms, shit or get off the pot!

"I don't want to believe. I want to KNOW." - Carl Sagan

Meanwhile, zero input on anything related to mask efficacy with regard to aerosolized virus spread, or prevention. Upon which some part of this wild goose chase supposedly had some bearing. 

This is now 10% of the pointless "studies" reviewed, and Nurse Claire has already dropped to a B+, and that only happens if she nails it out of the park with the next 46 studies in a row.

6) Post-operative wound infections and surgical face masks: a controlled study

Abstract:

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 designed 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 random 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 greater than 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 indicated 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 [on] by a healthy operating team.

 Aesop summary: 

A) WHO "reported a 50% decrease"?? 

B) If that's true, how come your survey revealed only a "statistically insignificant" decrease?? I'm going with an error variance range of somewhere around ±25% means you're both full of shit. Call me crazy, but if my paycheck was ±25%, I'd be in the HR office every payday.

C) WHICH bacterial species were cultured from the wounds? 

D) Are ANY of those bacterial species transmitted via oral mucosa vectors? Or are NONE of them thusly transmitted? If it's the latter, the only thing you've done is highlight that you have a bigger problem, and it has nothing to do with masks or no masks. And you're looking in the wrong place. Are the post-operative infections coming from sloppy dressing changes? Sloppy post-op procedure by staff? Dirty instruments? Infected relatives? Dirty underwear? Patients finger-banging the site with their dirty booger hooks, after scratching their own asses? You have no fucking clue. 

E) If masks "don't make any difference", how is it that they "may be used to protect the operating team...from airborne infections"?? You can't have it both ways, Slick. Either they prevent infections, or they don't. Bazinga!

F) If masks don't matter for "a healthy operating team", what about when someone comes to work sick? Like they do all the time. Parachutes aren't necessary for a perfectly good aircraft, either. Until you find out there's no such thing as a perfectly good aircraft.

G) The use of masks "might" be reconsidered? Weasel words are weasel words. And you had 3,088 cases upon which to make a decision. If 3,088 cases isn't enough, how many before you feel safe picking a side? 10,000? 1,000,000? Or should we just push the decision off until you retire? Or just until after your grant money for the study is deposited? Or was your survey so vague and imprecise that no logical and rational conclusion could ever be reached? Whose fault would that be, praytell?

In fairness, props where they're due: They gathered a statistically valid sample size for both groups. They looked at the data they obtained. What they didn't do, was isolate one sole variable. They attempted to do this with mask weeks vs. unmask weeks. But they have no wild idea if all, or none, of the post-operative infections came from the team's oral mucosa. Or not. Which is kind of relevant to the entire question of masks or no masks, and whether they matter for bacteriological infections. Or at all. Which was kind of the exact point they were attempting to study. So their effort was total shitburgers.

Back to our, and more specifically Nurse Claire's contentions: this says, yet again, Jack and Shit about masks' efficacy at stopping the spread of aerosolized viruses. You'd think after digging six studies deep, somebody would've noticed that. 

Three up, three down; no hits, and no runs for Team Claire. I can hardly wait to get at the next 45 wastes of time and bandwidth at this rate, and only fifteen more posts, after seeing the enormous pile of irrelevance to the topic in the first two dives into this outhouse reservoir.

But wait! There's more!