Hygiene and room climate in the operating room

Area of Science:

• Surgical Infection Prevention
• Operating Room Air Quality
• Hospital Ventilation Systems

Background:

• Surgical site infections (SSIs) are a significant concern in healthcare settings.
• The role of airborne transmission in SSIs is often debated.
• Existing operating room (OR) ventilation systems may not optimize conditions for both patients and staff.

Purpose of the Study:

• To evaluate the primary sources of airborne contamination in surgical site infections.
• To assess the effectiveness of ultra-clean air systems and HEPA filtration in reducing SSIs.
• To identify factors within the OR that can compromise air quality and ventilation efficacy.

Main Methods:

• Literature review on surgical site infections and air quality.
• Analysis of the impact of ultra-clean air systems and HEPA filters.
• Examination of factors affecting laminar air-flow systems in ORs.

Main Results:

• Staff and patient skin are more significant sources of SSIs than ventilation systems.
• Ultra-clean air systems show limited benefit except in high-risk surgeries like orthopaedic implant procedures.
• HEPA filters are only necessary within ORs, not adjacent areas.
• Operating lamps, surgical team, forced air-warming systems, and cooling equipment can disrupt ultra-clean air fields.

Conclusions:

• Antimicrobial prophylaxis and ultra-clean air can reduce SSI incidence.
• Ventilation systems require optimization to account for OR activity and equipment.
• Further research is needed to develop improved OR climate control strategies.