Microbial Load in Septic and Aseptic Procedure Rooms

Abstract

These data do not suggest that septic and aseptic procedure rooms need to be separated. In interpreting the findings, one should recall that the study was not planned as an equivalence or non-inferiority study. Wherever patient safety is concerned, high-level safety concepts should only be demoted to lower levels if new and convincing evidence becomes available.

Clinical Issues — September 2023

“…Microbial sedimentation samples were measured before the procedure and at completion of the procedure. Similar to the other two studies, no significant differences were found in room air microbial concentrations or surface sedimentation between the infected and noninfected procedures performed 5 …”

“…In three studies investigating performance of a noninfected procedure (ie, Class I or II) after an infected procedure (ie, Class III or IV), no differences in infection rates 3 or environmental contamination 4,5 were found. In the first study, 83 patients who underwent arthroplasty procedures in an OR that had been used recently for a patient with a known infection were compared with 321 similar patients (ie, demographics, surgery type) who underwent surgery in an OR that had not been used recently for a patient with an infection (ie, control group).…”

Guideline for environmental cleaning

“…Other items in the list include anesthesia equipment (e.g., IV poles and pumps), patient monitors, OR beds, table straps, bed attachments, positioning and transfer devices, overhead procedure lights, tables and Mayo stands, and mobile and fixed equipment (e.g., stools, pneumatic tourniquets, viewing monitors) . New to this update, but included in a previous 2008 version of the guideline, is the recommendation that performing terminal cleaning or closing the OR after a contaminated or dirty procedure is not required . “We added this back in based on studies showing that there is no greater risk of patients getting an infection if their surgery is performed following a contaminated procedure compared with a clean procedure,” deKay said.…”

Effectiveness of architectural separation of septic and aseptic operating theatres for improving process quality and patient outcomes: a systematic review

“…In 2017, an exploratory analysis of 16 septic and 14 aseptic general surgical procedures performed in a single theatre without laminar air flow showed no differences in bacterial air contamination and sedimentation [1]. Based on the results, an accompanying editorial concluded that “separation of septic and aseptic surgical areas is obsolete” [2].…”