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Operating room environment.

M A Ritter1

  • 1Center for Hip and Knee Surgery, Kendrick Memorial Hospital, Mooresville, IN 46158, USA.

Clinical Orthopaedics and Related Research
|December 28, 1999
PubMed
Summary
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Operating room personnel are the primary source of bacteria, leading to sepsis after joint replacement. Reducing personnel and surgery time, alongside using inclusive gowns and environmental controls, can significantly decrease contamination.

Area of Science:

  • Infection control in surgical environments
  • Microbiology of operating rooms
  • Orthopedic surgery complications

Background:

  • Sepsis following total joint replacement is a significant complication.
  • Environmental contamination in operating rooms is a direct cause of surgical site infections.
  • Operating room personnel are identified as a major source of bacterial contamination.

Purpose of the Study:

  • To identify the primary sources of bacterial contamination in the operating room.
  • To evaluate the effectiveness of various infection control measures in reducing environmental bacteria.
  • To provide recommendations for minimizing sepsis risk in total joint replacement surgery.

Main Methods:

  • Quantifying airborne bacteria colony-forming units (CFUs) in operating rooms with and without personnel.

Related Experiment Videos

  • Assessing the impact of inclusive gowns (e.g., hooded body exhaust) on bacterial shedding.
  • Evaluating the efficacy of environmental controls like laminar airflow and ultraviolet light.
  • Analyzing the sources of wound contamination, including direct fallout and contaminated equipment/hands.

    • Main Results:

    • Bacterial counts increased from 13 CFUs/sq ft/hour without personnel to over 400 CFUs/sq ft/hour during surgery.
    • Inclusive gowns are effective, but all personnel must wear them; face masks and head covers offer no environmental protection.
    • Laminar airflow or UV light reduced airborne bacteria by >90% at the wound and 60% in the room.
    • Wound contamination primarily occurs through direct environmental fallout and secondary contamination from equipment/hands.

    Conclusions:

    • Operating room personnel are the main contributors to environmental bacterial contamination.
    • Implementing inclusive gowns, reducing personnel numbers, and shortening surgery duration are crucial for infection control.
    • Advanced environmental controls like laminar airflow and UV light are highly effective in reducing airborne bacteria and preventing sepsis after total joint replacement.