scholarly journals Important interventions in the operating room to prevent bacterial contamination and surgical site infections

2021 ◽  
Author(s):  
Camilla Wistrand ◽  
Karin Falk-Brynhildsen ◽  
Ann-Sofie Sundqvist
Keyword(s):  
Operating Room ◽  
Bacterial Contamination ◽  
Surgical Site Infections

scholarly journals Bacterial contamination of protective lead garments in an operating room setting

2020 ◽  
Vol 21 (6) ◽  
pp. 234-240
Author(s):  
Ron Gilat ◽  
Ilan Mitchnik ◽  
Eran Beit Ner ◽  
Noam Shohat ◽  
Eran Tamir ◽  
...  
Keyword(s):  
Operating Room ◽  
Bacterial Contamination ◽  
Bacterial Load ◽  
Pseudomonas Stutzeri ◽  
Surgical Site Infections ◽  
Bacillus Species ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Bacillus Spp

Background: Protective lead garments (PLG) worn in the operating room are a potential source for bacterial colonisation and thus may increase the risk of intraoperative infection. The clinical significance of such bacterial contamination has yet been established. Although disinfection protocols have been employed, their effectiveness is also unknown. Objective: We sought to describe and compare the bacterial profile of PLGs with a focus on common pathogens involved in surgical site infections (SSI) and prosthetic joint infections (PJI). Methods: We studied body aprons and neck-thyroid protective shields. We sampled 20 body aprons and 21 neck PLGs, swabbing the inside and outside of the PLGs. Swabs were cultured on different media and the results were assessed and compared. Results: Of PLGs, 87.8% were contaminated. The neck-thyroid shield PLGs was generally more contaminated than body apron PLGs and exhibited significantly higher loads of Staphylococcus epidermidis ( P = 0.048). Other pathogen cultured were Micrococcus spp., Acinetobacter lwoffii ( A. lwoffii), Bacillus species ( Bacillus spp.), Moraxella osloensis ( M. osloensis) and Pseudomonas stutzeri ( P. stutzeri). No other common pathogens associated with SSI or PJI were detected. Conclusions: PLGs are heavily contaminated despite regular cleaning protocols. Neck PLGs are highly contaminated with potentially infectious agents. As neck PLGs are often directly exposed above the surgical sterile gown and the surgical field, measures should be undertaken to reduce their exposure and bacterial load, perhaps by suggesting users consider avoiding the use of intraoperative fluoroscopy when possible or alternatively supporting the use of body exhaust suits when PLGs are needed.

Comparison of two air sampling methods to monitor operating room air quality and assessment of air quality in two operating rooms with different ventilation systems in the national hospital of Sri Lanka

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Tshokey Tshokey ◽  
Pranitha Somaratne ◽  
Suneth Agampodi
Keyword(s):  
Air Quality ◽  
Sri Lanka ◽  
Operating Room ◽  
Ventilation System ◽  
Surgical Site Infections ◽  
National Hospital ◽  
Air Contamination ◽  
Acceptable Method ◽  
The Difference ◽  
Laminar Air Flow

Air contamination in the operating room (OR) is an important contributor for surgical site infections. Air quality should be assessed during microbiological commissioning of new ORs and as required thereafter. Despite many modern methods of sampling air, developing countries mostly depended on conventional methods. This was studied in two ORs of the National Hospital of Sri Lanka (NHSL) with different ventilation system; a conventional ventilation (CV) and a laminar air flow (LAF). Both ORs were sampled simultaneously by two different methods, the settle plate and sampler when empty and during use for a defined time period. Laboratory work was done in the Medical Research Institute. The two methods of sampling showed moderate but highly significant correlation. The OR with CV was significantly more contaminated than LAF when empty as well as during use by both methods. Overall, the difference in contamination was more significant when sampled by the sampler. Differences in contamination in empty and in-use ORs were significant in both ORs, but significance is less in LAF rooms. The consistent and significant correlation between settle plate and sampler showed that the settle plate is an acceptable method. The LAF theatre showed less contamination while empty and during use as expected. Air contamination differences were more significant when sampled with sampler indicating that it is a more sensitive method. Both CV and LAF ORs of the NHSL did not meet the contamination standards for empty theatres but met the standards for in-use indicating that the theatre etiquette was acceptable.

scholarly journals Root cause analysis of epidural spinal cord stimulator implant infections with resolution after implementation of an improved protocol for surgical placement

2019 ◽  
Vol 20 (4) ◽  
pp. 185-190
Author(s):  
Forest W Arnold ◽  
Sarah Bishop ◽  
David Johnson ◽  
LaShawn Scott ◽  
Crystal Heishman ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Operating Room ◽  
Surgical Site Infections ◽  
Root Cause Analysis ◽  
Hospital Epidemiology ◽  
Cause Analysis ◽  
Root Cause ◽  
Cord Injury ◽  
Vancomycin Powder ◽  
To Receive

Background: Placing a spinal stimulator for the purpose of restoring paralysed function is a novel procedure; however, paralysis predisposes people to infection. Preventing surgical site infections is critical to benefit this population. Objective: The objective of this study was to review the root cause analysis of postoperative wound infections by a hospital epidemiology team following implantation of epidural spinal cord neurostimulators in patients with chronic spinal cord injury. Methods: A team was assembled to review the case of every individual who had been enrolled to receive a neurostimulator at the facility. A root cause analysis was performed evaluating five categories: the patient; equipment; facility/environment; procedure; and personnel. Findings: The root cause analysis included 11 patients. Two patients became infected. Three others dehisced their wound without becoming infected. All patients were given preoperative antibiotics on time. A mean of 17 personnel were in the operating room during surgery. Vancomycin powder was used in the patients who either dehisced their wound or became infected. Conclusions: The root cause analysis provides guidance for other institutions performing the same novel procedure. This analysis did not reveal a direct association, but did generate several areas for improvement including increasing pre-surgical screening, cleaning transient equipment (e.g., computer screens), limiting traffic in the operating room, using new sterile instruments for each stage of the procedure, not reopening the back incision, not applying vancomycin powder, and using an antimicrobial envelope for the stimulator.

scholarly journals Innovative Ventilation Technology for Operating Rooms

2018 ◽  
Vol 4 (1) ◽  
pp. 243-245 ◽  
Author(s):  
Sabine Gruber ◽  
Sebastian Buhl ◽  
Clemens Bulitta
Keyword(s):  
Operating Room ◽  
Clinical Setting ◽  
Bacterial Contamination ◽  
Ventilation System ◽  
Operating Rooms ◽  
Operating Theatre ◽  
Experimental Setting ◽  
Bacterial Burden

AbstractThe purpose of this work was to evaluate the decontamination potential of the Potok system both in an experimental setting in a research Operating Room (OR) with standalone Air Decontamination Units (Potok 150-M-01) and in a clinical setting in a real operating theatre in Moscow. Our experiments showed an impact of the Potok units on the bacterial contamination of the room air according to the Swedish SIS-TS 39:2015 standard. For the initial measurements in our research OR in Weiden this could be shown by a decrease of the bacterial burden at all three different measurement points (OR table, instrumentation tray, periphery). Also the subsequently done measurements in the Moscow hospital verified this decontaminating effectivity of the Potok system. In this case the initial background contamination of the operating theatre was higher than in the research OR in Germany. This bacterial burden could be effectively decreased by the use of the installed Potok based ventilation system.

Teaching in the operating room: A risk for surgical site infections?

2020 ◽  
Vol 220 (2) ◽  
pp. 322-327
Author(s):  
Edin Mujagic ◽  
Henry Hoffmann ◽  
Savas Soysal ◽  
Tarik Delko ◽  
Robert Mechera ◽  
...  
Keyword(s):  
Operating Room ◽  
Surgical Site Infections

scholarly journals Deep brain stimulator implantation in a diagnostic MRI suite: infection history over a 10-year period

2017 ◽  
Vol 126 (1) ◽  
pp. 108-113 ◽  
Author(s):  
Alastair J. Martin ◽  
Paul S. Larson ◽  
Nathan Ziman ◽  
Nadja Levesque ◽  
Monica Volz ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Operating Room ◽  
Infection Rate ◽  
Brain Stimulation ◽  
Pulse Generator ◽  
Surgical Site Infections ◽  
Air Filtration ◽  
Staphylococcus Epidermis ◽  
Mri Guided ◽  
Deep Brain

OBJECTIVE The objective of this study was to assess the incidence of postoperative hardware infection following interventional (i)MRI–guided implantation of deep brain stimulation (DBS) electrodes in a diagnostic MRI scanner. METHODS A diagnostic 1.5-T MRI scanner was used over a 10-year period to implant DBS electrodes for movement disorders. The MRI suite did not meet operating room standards with respect to airflow and air filtration but was prepared and used with conventional sterile procedures by an experienced surgical team. Deep brain stimulation leads were implanted while the patient was in the magnet, and patients returned 1–3 weeks later to undergo placement of the implantable pulse generator (IPG) and extender wire in a conventional operating room. Surgical site infections requiring the removal of part or all of the DBS system within 6 months of implantation were scored as postoperative hardware infections in a prospective database. RESULTS During the 10-year study period, the authors performed 164 iMRI-guided surgical procedures in which 272 electrodes were implanted. Patients ranged in age from 7 to 78 years, and an overall infection rate of 3.6% was found. Bacterial cultures indicated Staphylococcus epidermis (3 cases), methicillin-susceptible Staphylococcus aureus (2 cases), or Propionibacterium sp. (1 case). A change in sterile practice occurred after the first 10 patients, leading to a reduction in the infection rate to 2.6% (4 cases in 154 procedures) over the remainder of the procedures. Of the 4 infections in this patient subset, all occurred at the IPG site. CONCLUSIONS Interventional MRI–guided DBS implantation can be performed in a diagnostic MRI suite with an infection risk comparable to that reported for traditional surgical placement techniques provided that sterile procedures, similar to those used in a regular operating room, are practiced.

scholarly journals Perioperative Bacterial Contamination from Patients on Contact Precaution in Operating Room Environment

2020 ◽  
Author(s):  
Hajime Kanamori ◽  
William A Rutala ◽  
Maria F Gergen ◽  
David J Weber
Keyword(s):  
Operating Room ◽  
Bacterial Contamination ◽  
Multidrug Resistant ◽  
Aerobic Bacteria ◽  
Contact Precaution ◽  
Contact Precautions

Abstract We investigated the microbial burden on the operating room environment when patients on contact precautions for a multidrug-resistant pathogen received surgery. Our study demonstrated that the perioperative environment was contaminated with aerobic bacteria and MRSA after surgery, and that MRSA persisted environmentally even after cleaning/disinfection, highlighting the need for meticulous cleaning/disinfection in the perioperative environment.

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