Wound Ventilation With Ultraclean Air for Prevention of Direct Airborne Contamination During Surgery

2004 ◽  
Vol 25 (4) ◽  
pp. 297-301 ◽  
Author(s):  
Mikael Persson ◽  
Jan van der Linden
Keyword(s):  
Operating Room ◽  
Median Number ◽  
Airborne Particles ◽  
University Hospital ◽  
Surgical Wound ◽  
Wound Model ◽  
Wound Contamination ◽  
Room Ventilation ◽  
Airborne Contamination ◽  
Number Of Particles

AbstractBackground and Objective:Despite the novelties in operating room ventilation, airborne bacteria remain an important source of surgical wound contamination. An ultraclean airflow from the ceiling downward may convey airborne particles from the surgical team into the wound, thus increasing the risk of infection. Therefore, similar ventilation from the wound upward should be considered. We investigated the effect of wound ventilation on the concentration of airborne particles in a wound model during simulated surgery.Design:Randomized experimental study simulating surgery with a wound cavity model.Setting:An operating room of a university hospital ventilated with ultraclean air directed downward.Interventions:Particles 5 um and larger were counted with and without a 5-cm deep cavity and with and with-out the insufflation of ultraclean air.Results:With the surgeon standing upright, no airborne particles could be detected in the wound model. In contrast, during simulated operations, the median number of particles per 0.1 cu ft reached 18 (25th and 75th percentiles, 12 and 22.25) in the model with a cavity and 15.5 (25th and 75th percentiles, 14 and 21.5) without. With a cavity, wound ventilation markedly reduced the median number of particles to 1 (range, 0 to 1.25;P< .001).Conclusions:To protect a surgical wound against direct airborne contamination, air should be directed away from the wound rather than toward it. This study provides supportive evidence to earlier studies that operating room ventilation with ultraclean air is imperfect during surgical activity and that wound ventilation may be a simple complement. Further clinical trials are needed.

Routes and Sources ofStaphylococcus aureusTransmitted to the Surgical Wound During Cardiothoracic Surgery Possibility of Preventing Wound Contamination by Use of Special Scrub Suits

2001 ◽  
Vol 22 (6) ◽  
pp. 338-346 ◽  
Author(s):  
Ann Tammelin ◽  
Anna Hambræus ◽  
Elisabeth Ståhle
Keyword(s):  
Operating Room ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Cardiothoracic Surgery ◽  
Surgical Wound ◽  
Skin Preparation ◽  
Air Samples ◽  
Wound Contamination ◽  
Surgical Wounds ◽  
Airborne Contamination

AbstractObjectives:To trace the routes of transmission and sources ofStaphylococcus aureusfound in the surgical wound during cardiothoracic surgery and to investigate the possibility of reducing wound contamination, with regard to total counts of bacteria andS aureus, by wearing special scrub suits.Methods:A total of 65 elective operations for coronary artery bypass graft with or without concomitant valve replacement were investigated. All staff present in the operating room wore conventional scrub suits during 33 operations and special scrub suits during 32 operations. Bacteriological samples were taken from the hands of the scrubbed team after surgical scrub but before putting on sterile gowns and gloves and from the patients' skin (incisional area of sternum and vein harvesting area of legs) after preoperative skin preparation with chlorhexidine gluconate. Air samples were taken during operations. Bacteriological samples also were taken from the subcutaneous walls of the surgical wound just before closing the wound. Total counts of bacteria on sternal skin and wound walls (colony-forming units [CFUs//cm2) were calculated, as well as total counts of bacteria in the air (CFUs/m3). Strains ofS aureusrecovered from the different sampling sites were compared by pulsed-field gel electrophoresis (PFGE).Results:Special scrub suits significantly reduced total counts of bacteria in air compared to conventional scrub suits (P=.002). The number of air samples in whichS aureuswas found was significantly reduced by special scrub suits compared with conventional scrub suits (P=.016; relative risk, 4.4; 95% confidence interval [CI95], 1.3-14.9]). By use of PFGE, it was possible to identify two cases of possible airborne transmission ofS aureuswhen wearing conventional scrub suits, whereas no case was found when wearing special scrub suits. When exposed to airborneS aureus, the concomitant sternal carriage ofS aureuswas a risk factor for havingS aureusin the wound.Conclusions:Use of tightly woven special scrub suits reduces the dispersal of total counts of bacteria and ofS aureusfrom staff in the operating room, thus possibly reducing the risk of airborne contamination of surgical wounds. The importance of careful preoperative disinfection of the patient's skin should be stressed.

scholarly journals A Systems Approach to Assess Transport and Diffusion of Hazardous Airborne Particles in a Large Surgical Suite: Potential Impacts on Viral Airborne Transmission

2020 ◽  
Vol 17 (15) ◽  
pp. 5404 ◽  
Author(s):  
Marc Garbey ◽  
Guillaume Joerger ◽  
Shannon Furr
Keyword(s):  
Operating Room ◽  
Systems Approach ◽  
Airborne Particles ◽  
Mathematical Framework ◽  
Airborne Transmission ◽  
Surgical Smoke ◽  
Airborne Contamination ◽  
Transport And Diffusion ◽  
And Diffusion

Airborne transmission of viruses, such as the coronavirus 2 (SARS-CoV-2), in hospital systems are under debate: it has been shown that transmission of SARS-CoV-2 virus goes beyond droplet dynamics that is limited to 1 to 2 m, but it is unclear if the airborne viral load is significant enough to ensure transmission of the disease. Surgical smoke can act as a carrier for tissue particles, viruses, and bacteria. To quantify airborne transmission from a physical point of view, we consider surgical smoke produced by thermal destruction of tissue during the use of electrosurgical instruments as a marker of airborne particle diffusion-transportation. Surgical smoke plumes are also known to be dangerous for human health, especially to surgical staff who receive long-term exposure over the years. There are limited quantified metrics reported on long-term effects of surgical smoke on staff’s health. The purpose of this paper is to provide a mathematical framework and experimental protocol to assess the transport and diffusion of hazardous airborne particles in every large operating room suite. Measurements from a network of air quality sensors gathered during a clinical study provide validation for the main part of the model. Overall, the model estimates staff exposure to airborne contamination from surgical smoke and biological material. To address the clinical implication over a long period of time, the systems approach is built upon previous work on multi-scale modeling of surgical flow in a large operating room suite and takes into account human behavior factors.

scholarly journals A Systems Approach to Assess Transport and Diffusion of Hazardous Airborne Particles in a Large Surgical Suite: Potential Impacts on Viral Airborne Transmission

2020 ◽  
Author(s):  
Marc Garbey ◽  
Guillaume Joerger ◽  
Shannon Furr
Keyword(s):  
Operating Room ◽  
Systems Approach ◽  
Airborne Particles ◽  
Mathematical Framework ◽  
Airborne Transmission ◽  
Surgical Smoke ◽  
Airborne Contamination ◽  
Transport And Diffusion ◽  
And Diffusion

Airborne transmission of viruses, such as the coronavirus 2 (SARS-CoV-2), in hospital systems are under debate: it has been shown that transmission of SARS-CoV-2 virus goes beyond droplet dynamics that is limited to 3-6 feet, but it is unclear if the airborne viral load is significant enough to ensure transmission of the disease. Surgical smoke can act as a carrier for tissue particles, viruses, and bacteria. To quantify airborne transmission from a physical point of view, we consider surgical smoke produced by thermal destruction of tissue during the use of electrosurgical instruments as a marker of airborne particle diffusion-transportation. Surgical smoke plumes are also known to be dangerous for human health, especially to surgical staff who receive long-term exposure over the years. There are limited quantified metrics reported on long-term effects of surgical smoke on staff's health. The purpose of this paper is to provide a mathematical framework and experimental protocol to assess the transport and diffusion of hazardous airborne particles in every large operating room suite. Measurements from a network of air quality sensors gathered during a clinical study provide validation for the main part of the model. Overall, the model estimates staff exposure to airborne contamination from surgical smoke and biological material. To address the clinical implication over a long period of time, the systems approach is built upon previous work on multi-scale modeling of surgical flow in a large operating room suite and takes into account human behavior factors.

Decreasing Airborne Contamination Levels in High-Risk Hospital Areas Using a Novel Mobile Air-Treatment Unit

2007 ◽  
Vol 28 (10) ◽  
pp. 1181-1186 ◽  
Author(s):  
V. Bergeron ◽  
G. Reboux ◽  
J. L. Poirot ◽  
N. Laudinet
Keyword(s):  
High Risk ◽  
Operating Room ◽  
High Efficiency ◽  
Nonthermal Plasma ◽  
Fungal Species ◽  
Airborne Particles ◽  
Treatment Unit ◽  
Air Treatment ◽  
Hospital Environments ◽  
Airborne Contamination

Objective.To evaluate the performance of a new mobile air-treatment unit that uses nonthermal-plasma reactors for lowering the airborne bioburden in critical hospital environments and reducing the risk of nosocomial infection due to opportunistic airborne pathogens, such asAspergillus fumigatus.Methods.Tests were conducted in 2 different high-risk hospital areas: an operating room under simulated conditions and rooms hosting patients in a pediatric hematology ward. Operating room testing provided performance evaluations of removal rates for airborne contamination (ie, particles larger than 0.5μm) and overall lowering of the airborne bioburden (ie, colony-forming units of total mesophilic flora and fungal flora per cubic meter of air). In the hematology service, opportunistic and nonpathogenic airborne fungal levels in a patient's room equipped with an air-treatment unit were compared to those in a control room.Results.In an operating room with a volume of 118 m3, the time required to lower the concentration of airborne particles larger than 0.5μm by 90% was decreased from 12 minutes with the existing high-efficiency particulate air filtration system to less than 2 minutes with the units tested, with a 2-log decrease in the steady-state levels of such particles (P<.01). Concurrently, total airborne mesophilic flora concentrations dropped by a factor of 2, and the concentrations of fungal species were reduced to undetectable levels (P<.01). The 12-day test period in the hematology ward revealed a significant reduction in airborne fungus levels (P<.01), with average reductions of 75% for opportunistic species and 82% for nonpathogenic species.Conclusion.Our data indicate that the mobile, nonthermal-plasma air treatment unit tested in this study can rapidly reduce the levels of airborne particles and significantly lower the airborne bioburden in high-risk hospital environments.

scholarly journals Carbon dioxide insufflation deflects airborne particles from an open surgical wound model

2017 ◽  
Vol 95 (1) ◽  
pp. 112-117 ◽  
Author(s):  
P. Kokhanenko ◽  
G. Papotti ◽  
J.E. Cater ◽  
A.C. Lynch ◽  
J.A. van der Linden ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Airborne Particles ◽  
Surgical Wound ◽  
Carbon Dioxide Insufflation ◽  
Wound Model

EFFICACY OF ANTIBIOTICS PROPHYLAXIS IN PATIENTS WITH LUMBAR DISC HERNIATION UNDERGOING LUMBAR DISCETOMY

2018 ◽  
Vol 8 (5) ◽  
pp. 14-19
Author(s):  
Tri Truong Van ◽  
Tri Tran Duc Duy ◽  
Khai Vo Le Quang
Keyword(s):  
Surgical Site Infection ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
University Hospital ◽  
Site Infection ◽  
Surgical Wound ◽  
A Prospective Study ◽  
Length Of Hospitalization

Introduction: Surgical wound infection in developing coutries is about 3%. Antibiotics prophylaxis may help to reduce the surgical site infection. The objective of this study was to evaluate the efficacy of antibiotics prophylaxis in patients with lumbar disc herniation who were treated with lumbar discectomy at Hue University hospital. Materials and Methods: A prospective study was conducted at Hue University hospital from March 2015 to May 2018 on 54 patients with lumbar disc herniation who were used antibiotics prophylaxis when undergoing discectomy. Results: The infection rate in our study was 0%. Antibiotics prophylaxis reduced the length of hospitalization as well as the medical cost. Conclusion: Antibiotics prophylaxis was effective in preventing surgical site infection despite the fact that the condition of operating rooms did not meet the standard rules. Key words: prophylaxis antibiotics, lumbar disc herniation

scholarly journals Modeling of aerosol transmission of airborne pathogens in ICU rooms of COVID-19 patients with acute respiratory failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cyril Crawford ◽  
Emmanuel Vanoli ◽  
Baptiste Decorde ◽  
Maxime Lancelot ◽  
Camille Duprat ◽  
...  
Keyword(s):  
Ventilation System ◽  
Medical Personnel ◽  
Airborne Particles ◽  
Proof Of Concept ◽  
Dynamics Model ◽  
Treatment Unit ◽  
Normal Breathing ◽  
Air Flows ◽  
Boltzmann Method ◽  
Number Of Particles

AbstractThe COVID-19 pandemic has generated many concerns about cross-contamination risks, particularly in hospital settings and Intensive Care Units (ICU). Virus-laden aerosols produced by infected patients can propagate throughout ventilated rooms and put medical personnel entering them at risk. Experimental results found with a schlieren optical method have shown that the air flows generated by a cough and normal breathing were modified by the oxygenation technique used, especially when using High Flow Nasal Canulae, increasing the shedding of potentially infectious airborne particles. This study also uses a 3D Computational Fluid Dynamics model based on a Lattice Boltzmann Method to simulate the air flows as well as the movement of numerous airborne particles produced by a patient’s cough within an ICU room under negative pressure. The effects of different mitigation scenarii on the amount of aerosols potentially containing SARS-CoV-2 that are extracted through the ventilation system are investigated. Numerical results indicate that adequate bed orientation and additional air treatment unit positioning can increase by 40% the number of particles extracted and decrease by 25% the amount of particles deposited on surfaces 45s after shedding. This approach could help lay the grounds for a more comprehensive way to tackle contamination risks in hospitals, as the model can be seen as a proof of concept and be adapted to any room configuration.

Sign in / Sign up

Export Citation Format

Share Document