Wound disinfection with ultraviolet radiation

Area of Science:

• Surgical Infection Prevention
• Microbiology
• Environmental Hygiene in Healthcare

Background:

• Surgical site infections (SSIs) are a significant concern in total joint arthroplasty (TJA).
• Operating room (OR) contamination by airborne bacteria is a primary risk factor for SSIs.
• Conventional ventilation systems may not adequately control bacterial levels in the OR.

Purpose of the Study:

• To compare the efficacy of ultraviolet C (UVC) irradiation and protective clothing against filtered vertical laminar flow in reducing bacterial contamination during TJA procedures.
• To assess the impact of UVC on both airborne bacteria and bacteria within surgical wounds.

Main Methods:

• Bacteria counts in air and wounds were measured during the initial 20 minutes of TJA in four different OR environments.
• Environments tested included conventional, UVC clothing, UVC irradiation (100 and 300 microW cm-2 s-1), and laminar flow.
• UVC was activated post-incision to evaluate its effect on pre-existing wound bacteria.

Main Results:

• UVC clothing reduced air counts by 38% and wound counts by 66%.
• UVC at 100 microW cm-2 s-1 reduced air counts by 81% and wound counts by 87%.
• UVC at 300 microW cm-2 s-1 and laminar flow reduced air counts by 91-92% and wound counts by 92%.
• In UVC theatres, wound bacterial counts were lower than expected from air counts, suggesting direct bacterial killing within wounds.

Conclusions:

• Both UVC protective clothing and UVC irradiation are highly effective in reducing airborne bacteria during TJA.
• UVC irradiation demonstrates significant efficacy in reducing bacterial load within surgical wounds, comparable to laminar flow.
• UVC technology presents a viable and effective strategy for enhancing infection control in surgical settings.