Ultraviolet radiation compared to an ultra-clean air enclosure. Comparison of air bacteria counts in operating rooms

Abstract

Clean air in the operating room is important during joint replacement surgery. We compared monochromatic ultraviolet radiation of254 nm with the use ofa Charnley-Howorth air enclosure by bacterial air-sampling during 113 total hip arthroplasties. Air samples were taken continuously at the edge of the wound and every 15 minutes at a site 130 cm from the operating table. We also tested the effect of occlusive clothing for all personnel.

207-nm UV Light - A Promising Tool for Safe Low-Cost Reduction of Surgical Site Infections. I: In Vitro Studies

“…However UV radiations in the wavelength range emitted by a germicidal lamp are a human health hazard, causing roughly equal levels of biological damage in human cells as well as bacteria [12]–[14], and are clearly linked with skin cancer [15], [16] and cataract induction [17], [18]. These health hazard to human skin and eyes necessitate the use of cumbersome protective clothing, hoods and eye shields for the surgical staff and the patient [8], [19], and this has prevented widespread use of the UV wound irradiation technique during surgery.…”

Letters to the Editor

“…Carlsson et al also demonstrated that UV radiation reduced the bacterial contamination of ambient air at the wound site and throughout the op- Letters to the Editor erating room [6]. Considering that Lidwell et al [7] demonstrated a direct relationship between airborne bacterial counts and the frequency of prosthetic device infection in a multicenter study of more than 8,000 total hip and knee arthroplasties, and that collected series suggest that UV radiation can reduce the infection rate by almost 82% after total hip arthroplasty [8], it is reasonable to hypothesize that other types of surgery might also benefit.…”

“…Indeed, infection rates have been decreased by UV radiation after neurosurgical and cardiothoracic operations [8]. Recently, Brown et al prospectively followed 1,717 patients who underwent open cardiac operations (85% involving coronary bypass grafting) under UV-C radiation [9].…”

Current Concepts for Clean Air and Total Joint Arthroplasty: Laminar Airflow and Ultraviolet Radiation: A Systematic Review

“…Lidwell [25] reported a similar level of decontamination can be achieved with either LAF or UVL at 300 lW/cm 2 but only if there is relatively low contamination present to begin with. Other studies demonstrated colony counts in air treated with UVL at 290 lW/cm 2 were less than in operating rooms with Charnley-Howarth vertical LAF enclosures [3]. Taylor et al [46] performed a similar study in LAF operating rooms using UVL at 300 lW/cm 2 and looked at colony counts on the wound edges and in the air during THA.…”

“…The efficacy of UVL, specifically UVGI, for intraoperative infection control is not well defined in modern operating room environments. Several investigators have shown that UVL is reduces the risk of surgical site infection or has been used in conjunction with LAF or body exhaust techniques [3,39,46]. Initial levels of ultraviolet radiation used were selected based on health and safety concerns, but more recent studies have used intensities of up to 300 lW/cm 2 without reporting side effects [39].…”