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Area of Science:

  • Surgical Infection Prevention
  • Operating Room Management
  • Healthcare Epidemiology

Background:

  • Door openings in operating rooms (OR) disrupt sterile airflow and increase bacterial counts.
  • Maintaining a sterile environment is critical during orthopedic procedures like total joint arthroplasty (TJA).

Purpose of the Study:

  • To quantify the incidence of door openings during primary TJA surgeries.
  • To identify potential opportunities for reducing OR staff traffic and associated risks.

Main Methods:

  • A prospective observational study recorded door openings during 100 primary elective TJA surgeries.
  • Operating time was divided into preincision and postincision periods for detailed analysis.
  • OR personnel were unaware of the study's specific focus on door traffic.

Main Results:

  • A high average of 71.1 door openings occurred per TJA surgery (0.64 openings/min).
  • Nursing staff accounted for the majority of door openings (52.2%), followed by anesthesia (23.9%) and orthopedic staff (12.7%).
  • The preincision period showed a higher rate of door openings (0.84/min) compared to the postincision period (0.54/min).

Conclusions:

  • The incidence of door openings during TJA is substantial, posing a potential risk to OR sterility.
  • Variability in door opening frequency suggests that targeted interventions can effectively reduce traffic and improve OR environmental control.