Association of Airborne Microorganisms in the Operating Room With Implant Infections: A Randomized Controlled Trial

Area of Science:

• Surgical infection prevention
• Microbiology
• Biomedical engineering

Background:

• Surgical site infections (SSIs) are a significant complication following implant procedures.
• Airborne microbial contamination at incision sites is a potential risk factor for SSIs.
• Existing methods for controlling airborne microbes in operating rooms may not specifically target the incision site.

Purpose of the Study:

• To evaluate the association between airborne colony-forming units (CFU) at incision sites and the incidence of SSIs.
• To determine if a novel Air Barrier System can reduce airborne CFU at incision sites during surgery.
• To assess the impact of reduced airborne CFU on prosthesis-related infection rates.

Main Methods:

• A randomized controlled trial involving 300 patients undergoing major implant surgeries (hip arthroplasty, spinal procedures, vascular bypass).
• Patients were randomized to an intervention group using an Air Barrier System or a control group under standard conditions.
• Airborne CFU at incision sites were measured, and patients were followed for 12 months to track infection incidence.

Main Results:

• The intervention group demonstrated significantly lower CFU density at the incision site compared to the control group (P<.001).
• Higher airborne CFU density at the incision site was significantly associated with an increased incidence of implant infection (P=.021).
• Airborne CFU densities were four times greater in procedures with implant infection, and all four prosthesis infections occurred in the control group.

Conclusions:

• Reduction of airborne CFU specifically at the incision site during surgery is a viable strategy.
• The Air Barrier System effectively reduced airborne microbial load at the incision site.
• This approach may be an effective method for reducing prosthesis-related infections and improving patient outcomes.