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Updated: May 10, 2025

Safety Precautions and Operating Procedures in an ABSL-4 Laboratory: 3. Aerobiology
Published on: October 3, 2016
The Association Between OR Traffic and Airborne Microbial Counts During Two Types of Abdominal Surgeries
Abstract:
Airborne contamination via OR traffic (ie, number of personnel and door openings, personnel movement) can contribute to the deposit of microbes on surfaces and contribute to surgical site infections. Researchers at a midwestern health system used a mixed-methods approach to evaluate the association between OR traffic and microbial deposits during colon surgeries and abdominal hysterectomies using nonparticipant observations and agar settle plate testing. Door openings were at the low end of published rates, although some openings were for nonessential reasons. Door openings were strongly correlated with surgery duration (r58 = 0.72, P < .0001). Total microbial deposits were weakly correlated with increased door openings (r58 = 0.37, P < .004) and personnel (r58 = 0.27, P = .034), but most (83%) of the wound zone deposit values were below the established threshold. Perioperative personnel may be able to reduce microbial contamination risk by decreasing OR traffic.
Insights
Reducing operating room (OR) traffic, including door openings and personnel movement, can decrease microbial contamination. This study found OR traffic weakly correlated with microbial deposits, suggesting a modifiable risk factor for surgical site infections.
Area of Science:
- Healthcare-associated infections
- Operating room contamination
- Microbiology
Background:
- Airborne contamination in operating rooms (ORs) from traffic (personnel, door openings) can lead to microbial deposits on surfaces.
- These microbial deposits are a potential contributor to surgical site infections (SSIs).
Purpose of the Study:
- To evaluate the association between operating room (OR) traffic and microbial deposits during specific surgical procedures.
- To identify potential modifiable factors in OR traffic that could reduce contamination risk.
Main Methods:
- A mixed-methods approach was employed, combining nonparticipant observations and agar settle plate testing.
- Data were collected during colon surgeries and abdominal hysterectomies at a midwestern health system.
- OR traffic metrics (door openings, personnel numbers) were correlated with microbial deposit levels.
Main Results:
- Door openings were strongly correlated with surgery duration (r=0.72, P<0.0001).
- Total microbial deposits showed weak correlations with increased door openings (r=0.37, P<0.004) and personnel (r=0.27, P=0.034).
- The majority (83%) of wound zone deposit values were below established thresholds.
Conclusions:
- While most microbial deposits were below thresholds, OR traffic is a weakly associated factor.
- Perioperative personnel can potentially mitigate microbial contamination risk by controlling OR traffic.
- Strategies to decrease unnecessary door openings and personnel movement may enhance surgical site safety.
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