Operating Room Traffic Increases Aerosolized Particles and Compromises the Air Quality: A Simulated Study

Rezapoor, Maryam; Alvand, Abtin; Jacek, Elzbieta; Paziuk, Taylor; Maltenfort, Mitchell; Parvızı, Javad

doi:10.1016/j.arth.2017.10.012

Cited by 48 publications

(36 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In order to minimize cofounders such as increased particle load due to door opening and number of persons in the OR, those risk factors were standardized [ 19 , 21 ]. Door opening was reduced to a minimum: study nurse entered an empty OR, 2 scrub nurses entered OR to prepare surgical setting, patient and anaesthesiology team (2 persons) entered OR and surgical team entered OR.…”

Section: Methodsmentioning

confidence: 99%

“…Another factor which is often discussed but has not yet been thoroughly examined, is the turbulent air flow occurring at the margin of the LAF panel or even inside the LAF area due to obstacles. Only few studies compare concentration of suspended particles depending on position inside the LAF area or examines particles as potential bacteria carriers in the operative arthroplasty setting [ 11 , 12 , 19 ]. No study currently examines the quantitative and qualitative particle load or its distribution during total knee arthroplasty (TKA) in comparison with or without working of LAF system.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laminar air flow reduces particle load in TKA—even outside the LAF panel: a prospective, randomized cohort study

Kirschbaum

Hommel²,

Strache³

et al. 2020

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Released particles are a major risk of airborne contamination during surgery. The present prospective study investigated the quantitative and qualitative particle load in the operating room (OR) depending on location, time of surgery and use of laminar air flow (LAF) system. Methods The particle load/m3 was measured during the implantation of 12 total knee arthroplasties (6 × LAF, 6 × Non-LAF) by using the Met One HHPC 6 + device (Beckmann Coulter GmbH, Germany). Measurement was based on the absorption and scattering of (laser) light by particles and was performed at three different time-points [empty OR, setting up, ongoing operation) at 3 fixed measurement points [OR table (central LAF area), anaesthesia tower (marginal LAF area), surgical image amplifier (outside LAF area)]. Results Independent of time and location, all measurements showed a significantly higher particle load in the Non-LAF group (p < 0.01). With ongoing surgical procedure both groups showed increasing particle load. While there was a major increase of fine particles (size < 1 µm) with advancing activity in the LAF group, the Non-LAF group showed higher particle gain with increasing particle size. The lowest particle load in the LAF group was measured at the operating column, increasing with greater distance from the operating table. The Non-LAF group presented a significantly higher particle load than the LAF group at all locations. Conclusion The use of a LAF system significantly reduces the particle load and therefore potential bacterial contamination regardless of the time or place of measurement and therefore seems to be a useful tool for infection prevention. As LAF leads to a significant decrease of respirable particles, it appears to be a protective factor for the health of the surgical team regardless of its use in infection prevention. Level of evidence I.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laminar air flow reduces particle load in TKA—even outside the LAF panel: a prospective, randomized cohort study

Kirschbaum

Hommel²,

Strache³

et al. 2020

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Common causes include poor ventilation in the OR, long surgery times, frequent opening and closing of the OR door, frequent visitors, frequent entry and exit of medical personnel, and the use of foreign materials [11]. The air in the OR contains dust, cotton wool, skin cells, and respiratory droplets, which can all be potentially contaminated by bacteria [10,12]. Studies have shown that increased frequency of OR door opening and staff movement reduces the efficiency of the ventilation system and significantly increases air pollution [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…The air in the OR contains dust, cotton wool, skin cells, and respiratory droplets, which can all be potentially contaminated by bacteria [10,12]. Studies have shown that increased frequency of OR door opening and staff movement reduces the efficiency of the ventilation system and significantly increases air pollution [12][13][14][15]. In addition, compared to sliding doors, hinged doors have a greater risk of air pollution [16].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of infection control pathway in reducing postoperative infections in patients undergoing neurosurgery

Dong

Yuan

Ren

et al. 2020

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: The environment of the operating room (OR) is closely related to the postoperative complications of patients, and it is necessary to study, to what extent, the stringent management of the OR can reduce postoperative complications. Methodology: 426 patients who underwent surgery between January 2016 and December 2017 were selected from two class-100 laminar flow ORs of equivalent area, and were divided into an experimental group and a control group. Results: The experimental group had significantly lower total air-borne bacterial count in the OR than the control group 10 minutes before surgery (6.21 ± 4.14 vs. 11.58 ± 5.36 CFU/cm3), 10 minutes (15.67 ± 6.21 vs. 20.83 ± 5.78 CFU/cm3), 30 minutes (27.34 ± 8.18 vs. 39.56 ± 7.86 CFU/cm3) and 60 minutes (43.62 ± 7.66 vs. 51.63 ± 8.43 CFU/cm3) into surgery, and at the end of surgery (57.34 ± 7.67 vs. 69.33 ± 9.41 CFU/cm3) (all p < 0.05). The incidence rates of increased body temperature and leukocyte count 3 days post-surgery, and the duration of antibiotic therapy and hospital stay were significantly reduced in the experimental group compared to the control group (all p < 0.05). Furthermore, the total number of pathogens in the incision at 2 hours into surgery was also significantly lower in the experimental group than in the control group (p < 0.05). Conclusion: Stringent application of the infection control pathway is an efficacious measure for improving the air cleanliness of the neurosurgery OR, decreasing the incidence rates of postoperative complications and infection, as well as controlling pathogen transmission.

show abstract

“…They supported that OR contamination was more likely attributable to the effects of the personnel who enter the OR, rather than as a primary cause of DOs. Furthermore, Rezapoor et al [25] demonstrated that the laminar airflow was protective against the negative influences of the number of people, and partially of DOs. Smith et al [13] also showed that bacteria colony forming units cultured on plates placed in sterile basins in the OR during the operation were significantly negatively associated with any DOs, and the function of laminar air flow.…”

mentioning

confidence: 99%

General Assembly, Prevention, Operating Room - Personnel: Proceedings of International Consensus on Orthopedic Infections

Baldini¹,

Blevins²,

Gaizo³

et al. 2019

The Journal of Arthroplasty

View full text Add to dashboard Cite

Operating Room Traffic Increases Aerosolized Particles and Compromises the Air Quality: A Simulated Study

Cited by 48 publications

References 28 publications

Laminar air flow reduces particle load in TKA—even outside the LAF panel: a prospective, randomized cohort study

Laminar air flow reduces particle load in TKA—even outside the LAF panel: a prospective, randomized cohort study

Efficacy of infection control pathway in reducing postoperative infections in patients undergoing neurosurgery

General Assembly, Prevention, Operating Room - Personnel: Proceedings of International Consensus on Orthopedic Infections

Contact Info

Product

Resources

About