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Published on: January 7, 2019
Key factors influencing orthopaedic operating room contamination: Impact of human activity and Staphylococcus
Nicolas C I Ion1,2, Sorin R Fleaca1,2, Bogdan-Axente Bocea1,2
1Faculty of Medicine Lucian Blaga University of Sibiu Sibiu Romania.
Purpose:
The presence of pathogen microorganisms in the operating room remains a significant concern. This study aims to explore the factors influencing the presence of pathogens in the operating room.
Methods:
We analysed the presence of microorganisms in the operation theatre during total knee and hip replacement procedures for 33 patients performed in the same operation room (OR) over a period of 2 months. Three hundred and ninety-six samples were taken from several areas belonging to the sterile field. We have also analysed behavioural aspects in the OR that could influenced the potential contamination of the sterile field, such as the number of touches of the lamps, the temperature in the OR, the height of the operating table, the number of door openings.
Results:
Out of the total of 396 samples, 74 were positive. Most contaminations were with Staphylococcus epidermidis (45.45%). Most pathogens were found on the instrument table at the end of the intervention (27.27%). There is a correlation regarding the fact that at lower heights, the risk of contamination higher than if the table is raised more. We also find correlations between the number of operating room doors opened and the presence of field contamination, as well as between the number of touches of the lamps and the presence of pathogens on sterile fields.
Conclusion:
The presence of pathogens in the OR is influenced by the number of lamp touches, the frequency of door openings, and the increased number of people in the room. However, temperature and the height of the operating table do not have a significant impact on the occurrence of pathogens. The most commonly found pathogen in the OR was S. epidermidis. At the end of the surgery, the instrument table showed the highest percentage of pathogen presence.
Level Of Evidence:
Level IV, case series.
Insights
Operating room contamination by pathogens like Staphylococcus epidermidis is influenced by door openings and lamp touches. Reducing these factors can help maintain a sterile field during surgery.
Area of Science:
- Healthcare
- Infection Control
- Surgical Safety
Background:
- Pathogen microorganisms in the operating room (OR) pose a significant risk to patient safety.
- Maintaining a sterile field is crucial during surgical procedures to prevent healthcare-associated infections.
Purpose of the Study:
- To investigate factors influencing the presence of pathogens within the operating room environment.
- To identify key behavioral and environmental variables associated with sterile field contamination.
Main Methods:
- Microbial sampling of the sterile field during total knee and hip replacements (n=33).
- Analysis of environmental factors: operating room temperature, operating table height, door openings, and lamp touches.
- Correlation of microbial contamination with behavioral and environmental parameters.
Main Results:
- 74 out of 396 samples (18.7%) showed microbial contamination.
- Staphylococcus epidermidis was the most frequent pathogen (45.45%).
- Contamination correlated with increased door openings, more lamp touches, and lower operating table height.
Conclusions:
- Operating room pathogen presence is significantly influenced by the frequency of door openings and lamp touches.
- While not statistically significant in this study, the instrument table at the end of procedures showed a high percentage of pathogen presence.
- Strategies to minimize OR traffic and direct contact with sterile equipment are essential for infection control.
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