Operating Room Airborne Microbial Load: Nonscrubbed Staff Apparel Matters

Area of Science:

• Infection Control
• Operating Room Safety
• Microbiology

Background:

• Surgical site infections are a major cause of total joint arthroplasty failure.
• Previous research linked contamination levels, airborne particle counts, and staff numbers to infection risk.
• This study investigates the role of non-scrubbed operating room (OR) staff apparel in contributing to airborne microbial load.

Purpose of the Study:

• To evaluate the effectiveness of disposable coveralls versus hospital-laundered scrubs in reducing airborne microbial contamination.
• To quantify the microbial shedding from OR staff wearing different types of apparel.

Main Methods:

• Two methods were used: an isolation chamber study and a functional operating room study.
• Participants wore either scrubs or coveralls while performing tasks; settle plates and particle counters measured microbial shedding and airborne particles.
• Standardized maneuvers simulating OR activities were performed by lab members in a functional OR.

Main Results:

• Disposable coveralls demonstrated a significant reduction in viable particle settlement (approximately 10-fold lower) compared to scrubs in both isolation chamber and OR settings.
• Airborne particle concentrations were also substantially lower when wearing coveralls (77% reduction) versus scrubs.
• Statistical analysis confirmed significant differences (P < .01) in microbial load between the two apparel types.

Conclusions:

• Standard scrubs allow for the escape of contaminated particles into the OR environment due to their open nature.
• The one-piece design of coveralls effectively contains microbial shedding, significantly reducing airborne contamination.
• Findings support the use of coveralls in infection prevention strategies to enhance operating room safety.