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A Delayed Inoculation Model of Chronic Pseudomonas aeruginosa Wound Infection
Published on: February 20, 2020
Role of the environment of the operating suite in surgical wound infection
1Department of Medical Microbiology, University of Birmingham, United Kingdom.
Abstract:
Most surgical wound infections are acquired in the operating room from the patient's own microbial flora. The remainder are acquired mainly from the staff in the operating room during surgery. The inanimate environment (e.g., walls, floors, and surgical instruments) has little relevance to the spread of infection. Because the air is an important route of spread in joint prosthesis operations, the routine use of an ultraclean air system and exhaust-ventilated clothing is frequently recommended. The value of such a system in other types of clean surgery is doubtful, but other measures, such as the following, may provide similar results at less cost: reduction of the number of persons in the operating room; a policy of not opening doors during operations; the use of comfortable, washable, bacteria-impermeable clothing by the operating-room staff; and concentration of the airflow over the operation site rather than over the whole operating room.
Insights
Surgical site infections primarily originate from patient flora or operating room staff. While ultraclean air is vital for joint replacements, other clean surgeries may benefit from cost-effective measures like reduced personnel and improved staff attire.
Area of Science:
- Infection Control
- Surgical Hygiene
- Microbiology
Background:
- Surgical wound infections are a significant concern, often originating from endogenous microbial flora.
- Transmission routes include patient flora, operating room (OR) staff, and less commonly, the inanimate environment.
Purpose of the Study:
- To analyze the sources of surgical wound infections.
- To evaluate the efficacy of environmental controls and air systems in preventing surgical site infections (SSIs).
Main Methods:
- Review of infection sources in surgical settings.
- Analysis of the role of air quality and environmental factors in SSIs.
- Evaluation of infection control strategies.
Main Results:
- Most SSIs stem from the patient's own microbial flora or OR staff.
- The inanimate OR environment has minimal impact on infection spread.
- Airborne contamination is critical in joint prosthesis operations, necessitating ultraclean air systems.
Conclusions:
- Ultraclean air systems and specialized clothing are recommended for joint prosthesis surgeries.
- For other clean surgeries, cost-effective measures like reducing OR personnel, minimizing door openings, using impermeable staff clothing, and directed airflow can mitigate infection risks.
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