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

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 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.

Preparation of the Operating Room

2015 ◽  
Author(s):  
T. Forcht Dagi
Keyword(s):  
Hand Hygiene ◽  
Surgical Site Infection ◽  
Operating Room ◽  
Antimicrobial Prophylaxis ◽  
Patient Positioning ◽  
Surgical Site Infections ◽  
Radiological Protection ◽  
Site Infection ◽  
Or Efficiency ◽  
Standard Equipment

The history and general principles of OR design are discussed, including physical layout and design standards, which encompass the layout and storage of devices and equipment. As both patient and staff safety are paramount, all of the risks that can be mitigated by good design are discussed: biologic, ergonomic, chemical, and physical. Environmental issues in the OR are listed and include temperature, humidity, and lighting. The proper use, storage, and risks of electronic and mechanical devices are discussed. Infection control is addressed and includes hand hygiene, gloves and protective barriers, antimicrobial prophylaxis and nonpharmacologic preventive measures. A housekeeping section discusses the benefits of segregating clean, clean-contaminated, and dirty cases. OR scheduling is noted. Tables outline International Commission on Radiological Protection–recommended radiation dose limits; key principles of the Joint Commission Universal Protocol; devices used in the operating room; standard equipment for endovascular operating rooms; benefits of voice activation technology in the laparoscopic operating room; criteria for defining a surgical site infection; factors that contribute to the development of surgical site infection (SSI); Centers for Disease Control and Prevention hand hygiene guidelines; distribution of pathogens isolated from surgical site infections: operating room cleaning schedules; classification of operations in relation to the epidemiology of SSIs; and basic principles of OR efficiency. Figures depict patient positioning and basic components of an ultrasound transducer, This review contains 3 figures, 12 tables, and 214 references.

scholarly journals PD10-03 SIMPLE OPERATING ROOM BUNDLE REDUCES SUPERFICIAL SURGICAL SITE INFECTIONS AFTER MAJOR UROLOGIC SURGERY

2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Sarah Vij ◽  
Ganesh Kartha ◽  
Venkatesh Krishnamurthi ◽  
Howard B Goldman ◽  
Michelle Ponziano
Keyword(s):  
Operating Room ◽  
Surgical Site Infections ◽  
Urologic Surgery
Sign in / Sign up

Export Citation Format

Share Document