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Environmental controls in operating theatres.

S Dharan¹, D Pittet

¹Infection Control Programme, Department of Internal Medicine, University of Geneva Hospitals, Switzerland.

The Journal of Hospital Infection

|July 2, 2002

Summary

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Airborne bacteria in operating rooms are a concern for surgical-site infections. Ultra-clean air systems with HEPA filters significantly reduce infection rates in implant surgery.

Area of Science:

Infection control in surgical environments.
Environmental microbiology and hospital hygiene.

Background:

Surgical-site infection (SSI) is a major surgical complication, often caused by normal skin flora.
The role of airborne bacteria in SSIs, particularly in conventionally ventilated operating rooms, remains debated.
Modern operating theatres utilize filtered air (removing particles ≥5 µm) or laminar-flow systems with HEPA filters (removing particles ≥0.3 µm) for implant surgery.

Purpose of the Study:

To evaluate the significance of airborne bacteria in surgical environments.
To discuss current ventilation standards and their effectiveness in controlling microbial contamination.
To assess the suitability of cleanroom technology standards for operating theatres.

Main Methods:

Review of existing literature on operating theatre ventilation and bacterial contamination.

Related Experiment Videos

Comparison of conventional plenum ventilation with laminar-flow systems using HEPA filters.

Discussion of particle measurement standards versus bacterial air sampling.

Main Results:

Ultra-clean air systems with HEPA filtration have demonstrated significant reductions in infection rates for orthopaedic implant surgery.
Bacterial threshold limits and standardized sampling methods for operating rooms are not widely established.
Cleanroom technology standards, focusing on particle measurement, are increasingly being considered for hospital environments.

Conclusions:

Environmental bacterial sampling in operating theatres should be reserved for specific situations like epidemic investigations or protocol validation.
HEPA-filtered ventilation systems offer superior control of airborne particles relevant to surgical site infections.
Particle-based cleanroom standards may be more appropriate than bacterial sampling for assessing operating theatre air quality.