The Effect of Laminar Air Flow and Door Openings on Operating Room Contamination

Smith, Eric B.; Raphael, Ibrahim J.; Maltenfort, Mitchell; Honsawek, Sittisak; Dolan, Kyle; Younkins, Elizabeth A.

doi:10.1016/j.arth.2013.06.012

Cited by 107 publications

(68 citation statements)

References 32 publications

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“…The number of staff in the operating room (OR) is exponentially linked to the incidence of door openings during surgical interventions. 4 Door opening is believed to disrupt the laminar flow 5 and could thus lead to more bacteria and contamination over the wound and possibly lead to intraoperative infection. 4,[6][7][8][9][10][11] Thus far, only 1 study has measured the incidence of door opening during TJA.…”

mentioning

confidence: 99%

Traffic in the operating room during joint replacement is a multidisciplinary problem

Bédard

Pelletier-Roy

Angers-Goulet

et al. 2015

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Traffic in the operating room during joint replacement is a multidisciplinary problemBackground: Door openings disrupt the laminar air flow and increase the bacterial count in the operating room (OR). We aimed to define the incidence of door openings in the OR during primary total joint arthroplasty (TJA) surgeries and determine whether measures were needed and/or possible to reduce OR staff traffic. Methods:We recorded the number of door openings during 100 primary elective TJA surgeries; the OR personnel were unaware of the observer's intention. Operating time was divided into the preincision period, defined as the time from the opening of surgical trays to skin incision, and the postincision period, defined as time from incision to dressing application. Results:The mean number of door openings during primary TJA was 71.1 (range 35-176) with a mean operative time of 111.9 (range 53-220) minutes, for an average of 0.64 (range 0.36-1.05) door openings/min. Nursing staff were responsible for 52.2% of total door openings, followed by anesthesia staff at 23.9% and orthopedic staff at 12.7%. In the preincision period, we observed an average of 0.84 door openings/min, with nursing and orthopedic personnel responsible for most of the door openings. The postincision period yielded an average of 0.54 door openings/min, with nursing and anesthesia personnel being responsible for most of the door openings. Conclusion:There is a high incidence of door openings during TJA. Because we observed a range in the number of door openings per surgery, we believe it is possible to reduce this number during TJA.Contexte : Les ouvertures de porte perturbent le flux laminaire et accroissent la numération bactérienne au bloc opératoire. Nous avons voulu mesurer l'incidence des ouvertures de porte au bloc opératoire durant les chirurgies pour prothèse articulaire totale (PAT) et déterminer si des correctifs étaient requis ou s'il était possible de réduire la circulation du personnel au bloc opératoire. Méthodes :Nous avons dénombré les ouvertures de porte durant 100 chirurgies électives primaires pour PAT; le personnel du bloc opératoire n'était pas au courant de l'intention de l'observateur. Le temps opératoire a été subdivisé en une période pré-incision, définie par l'intervalle entre l'ouverture des plateaux chirurgicaux et l'incision chirurgicale, et une période post-incision, définie par l'intervalle entre l'incision et l'application du pansement.

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mentioning

confidence: 99%

Traffic in the operating room during joint replacement is a multidisciplinary problem

Bédard

Pelletier-Roy

Angers-Goulet

et al. 2015

cjs

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“…Assim, quanto maior o número de pessoas dentro da SO ou de abertura da porta durante o ato cirúrgico, maior o risco de contaminação do ar 6 , o que pode, potencialmente, levar estes micro-organismos suspensos no ar ambiente até a ferida cirúrgica 7 .…”

Section: Discussionunclassified

Análise das variáveis ambientais em salas cirúrgicas: fontes de contaminação

Sevilha

Paiva²,

Poveda

2014

Rev. SOBECC

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“…Moreover, bacterial isolates are increased when LAF is interrupted in an OR by frequent opening of the doors (Smith et al 2013). Maintaining sterility of the surgical environment is viewed as even more critical when you have a significantly immunocompromised patient involved (Castro 2008).…”

Section: Discussionmentioning

confidence: 99%

Isolation protocol for patients with severe combined immune deficiency

Reid

Courtney

2015

LymphoSign Journal

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Infants with severe combined immune deficiency (SCID) typically present in the first few months of life with severe, recurrent, opportunistic infections, and without definitive treatment the condition is invariably fatal (Gaspar et al. 2013). Many centres believe that protective isolation is required for treatment of SCID patients once diagnosed, and the isolation protocol varies across institutions. This paper describes the isolation protocol for SCID requiring hematopoietic stem cell transplant (HSCT) that has been utilized at our institution for over the last 25 years. We believe that the profound immunodeficiency in SCID patients warrants a more restrictive treatment to limit the morbidity and mortality associated with HSCT. With this protocol, we have seen a very low infection rate in and have a very good survival rate for our SCID population.

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The Effect of Laminar Air Flow and Door Openings on Operating Room Contamination

Cited by 107 publications

References 32 publications

Traffic in the operating room during joint replacement is a multidisciplinary problem

Traffic in the operating room during joint replacement is a multidisciplinary problem

Análise das variáveis ambientais em salas cirúrgicas: fontes de contaminação

Isolation protocol for patients with severe combined immune deficiency

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