Association of Airborne Microorganisms in the Operating Room With Implant Infections: A Randomized Controlled Trial

Abstract

clinicaltrials.gov Identifier: NCT01610271 Infect Control Hosp Epidemiol 2016;1-8.

Minimizing Sources of Airborne, Aerosolized, and Contact Contaminants in the OR Environment

“…The likelihood, severity, and type of an SSI can be dependent on intrinsic factors, such as the patient's age and underlying comorbidities and the type and length of the surgical procedure 4 . Extrinsic factors in the OR, such as health care provider (HCP) behavior and practices that modify air movement, the physical environment, equipment, or surgical instruments, also can increase microbial contamination and the risk of SSI development 5‐13 . Patients and HCPs can help control the effects of these intrinsic and extrinsic factors with practices such as cessation of smoking, preoperative bathing, preoperative prophylactic antibiotics, alcohol‐based patient skin antisepsis, and maintenance of body temperature 2,4 …”

“…In the OR environment, microbial contamination can occur through an airborne or contact route. The potential exists for microbes to infect the surgical incision through one of these routes, resulting in a reported association between OR contaminants and SSIs 5,6,8,11 . However, not every study has found a strong link between air or surface contamination and infection 7 .…”

“…Particle or CFU reduction at the incision site may decrease SSIs. Darouiche et al 8 conducted a randomized controlled trial with surgical patients and reduced airborne contaminants at the incision site using a device that created nonturbulent filtered air above the surgical field. Patients in the intervention group (n = 148) and in the control group (n = 146) had airborne CFUs and APCs measured at their incision sites.…”

“…4 Extrinsic factors in the OR, such as health care provider (HCP) behavior and practices that modify air movement, the physical environment, equipment, or surgical instruments, also can increase microbial contamination and the risk of SSI development. [5][6][7][8][9][10][11][12][13] Patients and HCPs can help control the effects of these intrinsic and extrinsic factors with practices such as cessation of smoking, preoperative bathing, preoperative prophylactic antibiotics, alcohol-based patient skin antisepsis, and maintenance of body temperature. 2,4 In the OR environment, microbial contamination can occur through an airborne or contact route.…”

“…The potential exists for microbes to infect the surgical incision through one of these routes, resulting in a reported association between OR contaminants and SSIs. 5,6,8,11 However, not every study has found a strong link between air or surface contamination and infection. 7 AORN's Guidelines for Perioperative Practice outlines the best practices to minimize OR contaminants.…”