Sliding doors: how their opening affects particulate matter levels?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Della Camera ◽  
G Spataro ◽  
G Cevenini ◽  
N Nante ◽  
F M De Marco ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Turbulent Flows ◽  
Air Flow ◽  
Surgical Site Infections ◽  
Operating Rooms ◽  
Laminar Flows ◽  
Wilcoxon Test ◽  
University Hospital ◽  
Door Opening ◽  
Particulate Contamination

Abstract Background The operating theatres (OTs) have adequate conditions to perform safe operations and to prevent surgical site infections. Opening doors can compromise these situations. Measurement of particulate contamination is a key point to check the effectiveness of preventive measures in the OTs. We analysed how openings impact in different type of OTs. Methods Between January/February 2020 a transversal study was conducted in 5 different types of OTs in a university hospital. Two had laminar flows, with 55 and 60 air changes/h; three had turbulent flows: OT-A (18 air changes/h, with 4 inlets from the ceiling), OT-B (23 air changes/h and air flow from the ceiling plenum), OT-C (16 air changes/h, air flow directed from one wall to the opposite wall and the main door laterally to the flow). Particulate matter (PM) measurements were carried out in 7 different points in each OT, alternating two conditions: a) doors closed; b) opening/closing the main door twice per minute. For each spot, in each condition, we recorded for several minutes the following parameters: particles (0.3, 0.5, 1, 3, 5, 10µ), room temperature (Ta), Relative Humidity (Rh), airspeed (Va). Comparison with the Wilcoxon test were made using STATA 14. Results In laminar flow, classified with better ISO levels (4), opening and closing the door the PM, for any size, increased not significantly (p > 0.05). The OTs with turbulent flows (ISO 5-6) had a higher particulate level than the laminar ones and greater variations with door openings. OT-A worsened significantly for all particles (p < 0.05) closing/opening the door. In contrast, OT-B and OT-C had a significant reduction of PM (p < 0.05). All 5 OTs had pressure falling to 0 at door opening; Ta, Rh and Va may be affected by different type air flows and design. Conclusions OTs parameters during door openings are influenced by different ventilation systems and room design. Laminar flows OTs are less affected, but innovative turbulent flows OTs can be just as effective. Key messages The operating rooms are affected by the door opening. Laminar flows operating rooms are less influenced by door openings than turbulent flows ones. Turbulent flow rooms have different performance depending on their construction characteristics.

scholarly journals A mobile device to reduce airborne particulate and prevent surgical site infections

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Messina ◽  
G Spataro ◽  
L Catarsi ◽  
M F De Marco ◽  
A Grasso ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Mobile Device ◽  
Particle Filtering ◽  
Surgical Site Infections ◽  
The United States ◽  
University Hospital ◽  
Phase Iii ◽  
Rank Test ◽  
Operation Conditions ◽  
Air Particulate

Abstract Background Surgical Site Infections (SSI) are the second main cause of Hospital Acquired Infections (HAI) in Europe and in the United States (US). In US and Europe hospitals the overall annual medical costs of HAI is about $40 billion and the SSI represent a relevant part of this spending. It is known that air particulate is a carrier of pathogen bacteria. The aim of this study is to verify if a mobile unit for air particle filtering can improve the environmental airborne conditions of an operating room (OR). Methods We carried out a cross sectional study in March 2018 in an Italian University Hospital. A novel mobile device to purify air was tested during surgical procedures. It is provided with: an air decontamination-recirculation system unit; a patented crystalline ultraviolet C reactor; a highly efficient particulate air filtering. The environmental contamination has been monitored in the following phases: I) device off and OR at rest; II) device off and OR in operational; III) device on and OR in operational; IV) device off and OR in operational. We used a particle counter to measure airborne particles of different sizes: 0.3; 0.5; 1.0; 3.0; 5.0; 10 µm. Air samples were withdrawn in four spots of the OR periphery. Wilcoxon rank test was used for the statistical analysis setting the significance level to 95% (p < 0.05). Results From phase II (device off) to phase III (device on), there was a reduction of any particulate matter size, ranging from 50% to 73% (p < 0.05). When the device has been turned off again (phase IV), particle dimensions of 0.3, 0.5, 1.0 and 3.0 µm were lower in the percentage range of 51-62% (p < 0,05). Particle dimensions of 5 and 10 µm were also lower in the range of 56% and 76%, respectively. Conclusions During mobile device operation, the amount of particulate matter remains significantly lower, reducing the probability of SSI. Key messages Air particulate in surgical room may play a role in preventing Surgical Site Infections. The mobile device was able to significantly improve air quality during real operation conditions.

scholarly journals Opening Doors in the Operating Rooms: An Intervention and Outcome Study

2020 ◽  
Vol 41 (S1) ◽  
pp. s336-s336
Author(s):  
Akash Doshi ◽  
Rebecca Shadowen
Keyword(s):  
Air Flow ◽  
Surgical Site Infections ◽  
The United States ◽  
Audit And Feedback ◽  
Prospective Audit ◽  
Postoperative Infections ◽  
Door Opening ◽  
Significant Difference ◽  
Laminar Air Flow ◽  
Prospective Audit And Feedback

Background: Surgical site infections (SSIs) are a major cause of morbidity and mortality with an estimated cost of $3–10 billion annually in the United States. Laminar air flow in the operating room (OR) is 1 factor in reducing SSIs. Opening the OR door results in interruption of laminar air flow. As a part of annual infection prevention evaluation of our facility, we observed cases in the OR in which we identified excessive unnecessary door openings during surgical cases. We report an intervention in door openings in the OR and the effect on infection rate after surgery. Methods: We conducted an observational analytical study using prospective audit and feedback. Door-opening counters were placed on 4 OR doors. Each day, they were reset and the number was logged for each case by the circulating nurse. A baseline number of door openings was established between April 18, 2019, and May 2, 2019. Subsequently, daily feedback sheets were provided to all persons involved in the previous day’s procedures detailing the rationale to limit unnecessary door openings and the number of door openings that had occurred during the case(s) in which they were specifically involved from May 3, 2019, to June 4, 2019. Analyses of postoperative infection rates compared with historical controls were conducted. Using Stata version 15 statistical software, independent sample t tests were performed to see the difference between control and intervention groups. A CI 95% was set for significance. Results: There were no differences between control and intervention groups with the number of procedures (71 vs 80), OR, duration of procedure, or type of case. Outliers due to vibration of doors triggering the counters were removed, and door stabilizations were performed throughout the study. After removing outliers, there were no differences in control groups and interventions groups (39 vs 43). An independent sample t test showed a significant difference in the mean number of door openings between the control and intervention groups: 32.13 versus 24.84 (P < .05 and P = .0072). There have been no postoperative infections in any of the cases in the study to date compared to an overall annual rate of 1.5% in 2018 at our facility. Conclusions: Prospective audit and feedback to OR staff can reduce the number of unnecessary door openings during operating procedures. The baseline number of door openings from this study was 25 per case. No postoperative infections occurred in the patients receiving surgery in this study.Funding: NoneDisclosures: None

Evaluation Study of Different Strategies for Detecting Surgical Site Infections Using the Hospital Information System at Lyon University Hospital, France

2012 ◽  
Vol 255 (5) ◽  
pp. 896-900 ◽  
Author(s):  
Solweig Gerbier-Colomban ◽  
Monique Bourjault ◽  
Jean-Charles Cêtre ◽  
Jacques Baulieux ◽  
Marie-Hélène Metzger
Keyword(s):  
Information System ◽  
Hospital Information System ◽  
Surgical Site Infections ◽  
Evaluation Study ◽  
University Hospital

scholarly journals The effect of obstructions and thermals in laminar-flow systems

1974 ◽  
Vol 72 (3) ◽  
pp. 415-423 ◽  
Author(s):  
W. Whyte ◽  
B. H. Shaw
Keyword(s):  
Laminar Flow ◽  
Special Reference ◽  
Flow System ◽  
Air Flow ◽  
Operating Rooms ◽  
Flow Systems

SUMMARYThe influence of obstructions and thermals on the air flow in unidirectional or laminar flow systems was studied with special reference to operating rooms. It was shown that thermals induced in the operating rooms would have little influence in the normal laminar-flow system. The importance however of obstructions such as operating lamps and personnel was shown.

Reduction of surgical site infections in low transverse cesarean section at a university hospital

2012 ◽  
Vol 40 (9) ◽  
pp. 820-825 ◽  
Author(s):  
May Mei-Sheng Riley ◽  
Deborah Suda ◽  
Khalil Tabsh ◽  
Annemarie Flood ◽  
David A. Pegues
Keyword(s):  
Cesarean Section ◽  
Surgical Site Infections ◽  
University Hospital

scholarly journals P100 EARLY POSTOPERATIVE WOUND COMPLICATIONS AFTER MIDLINE LAPAROTOMY CLOSURE WITH SMALL BITES TECHNIQUE: EXPERIENCE FROM A TERTIARY REFERRAL CENTRE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Adomas Gudelis ◽  
Gintaras Simutis ◽  
Julius Pacevicius
Keyword(s):  
Abdominal Wall ◽  
Surgical Site Infections ◽  
Wound Dehiscence ◽  
Patient Characteristics ◽  
University Hospital ◽  
Wound Complications ◽  
Tertiary Referral Centre ◽  
Midline Laparotomy ◽  
Group A ◽  
Wound Length

Abstract Aim To analyze the incidence and risk factors of surgical site infections (SSI) and wound dehiscence (WD) after closure of primary midline laparotomies with small-bites (SB) technique. Material and Methods Retrospective analysis using hospital prospective database of all midline abdominal wall closures (AWC) with SB technique performed in a University Hospital between December 2019 and February 2021. To achieve a proper protocol of AWC with SB technique, it is advised to have suture/wound length (SL/WL) – ratio of more than 4:1. Statistical analysis of the incidence of SSI and AWD, comparing the results when the protocol was properly used (A group) or not (B group), was performed. Between groups, no relevant differences were observed for patient characteristics. Results A total of 108 midline laparotomies were included for analysis. 55.5% of patients were male. The mean age was 62.8 years, mean body mass index was 24.3 kg/m2. 78.7% (85/108) were operated electively. SSI and WD have been recorded in 7 (6.5%) and 8 (7,4%) cases respectively. In 65 (60,2%) patients abdominal wall closure after primary laparotomy was achieved with proper protocol (group A). Median SL/WL in A and B group was 4.57 and 3.43 respectively. The rate of WD in A group (n = 1, 1,5%) was significantly (P=.006) lower than in B group (n = 7, 16,3%). Incidence of SSI was 7,7% (n = 5, A group) vs. 4,7% (n = 2; B group) (P=.420). Conclusions Using a proper AWC protocol has been effective to prevent WD in midline laparotomy.

Microbiology of Surgical Site Infections and Associated Antimicrobial Use Among Vietnamese Orthopedic and Neurosurgical Patients

2006 ◽  
Vol 27 (08) ◽  
pp. 855-862 ◽  
Author(s):  
Le Thi Anh Thu ◽  
Annette H. Sohn ◽  
Nguyen Phuc Tien ◽  
Vo Thi Chi Mai ◽  
Vo Van Nho ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Surgical Site Infections ◽  
University Hospital ◽  
Antimicrobial Use ◽  
Combination Drug ◽  
E Coli ◽  
Neurosurgical Patients ◽  
Drug Regimens ◽  
Study Population ◽  
Orthopedic Patients

Objectives. To determine the pathogens associated with surgical site infections (SSIs) and describe patterns of antimicrobial use and resistance in orthopedic and neurosurgical patients in a large university hospital in Vietnam. Design. Prospective cohort study. Setting. Cho Ray Hospital, Ho Chi Minh City, Vietnam. Patients. All patients who had operations during a 5-week study period. Results. Of 702 surgical patients, 80 (11.4%) developed an SSI. The incidence of SSI among orthopedic patients was 15.2% (48 of 315), and among neurosurgical patients it was 8.3% (32 of 387). Postoperative bacterial cultures of samples from the surgical sites were performed for 55 (68.8%) of the 80 patients with SSI; 68 wound swab specimens and 10 cerebrospinal fluid samples were cultured. Of these 78 cultures, 60 (76.9%) were positive for a pathogen, and 15 (25%) of those 60 cultures yielded multiple pathogens. The 3 most frequently isolated pathogens were Pseudomonas aeruginosa (29.5% of isolates), Staphylococcus aureus (11.5% of isolates), and Escherichia coli (10.3% of isolates). Ninety percent of S. aureus isolates were methicillin resistant, 91% of P. aeruginosa isolates were ceftazidime resistant, and 38% of E. coli isolates were cefotaxime resistant. All but 1 of the 702 patients received antimicrobial therapy after surgery, and the median duration of antimicrobial therapy was 11 days. Commonly used antimicrobials included aminopenicillins and second- and third-generation cephalosporins. Two or, more agents were given to 634 (90%) of the patients, and most combination drug regimens (86%) included an aminoglycoside. Conclusions. Our data indicate that the incidence of SSI is high in our study population, that the main pathogens causing SSI are gram-negative bacteria and are often resistant to commonly used antimicrobials, that the use of broad-spectrum antimicrobials after surgery is widespread, and that implementation of interventions aimed at promoting appropriate and evidence-based use of antimicrobials are needed in Vietnam.

Surgical-Site Infections Following Cesarean Section in an Estonian University Hospital: Postdischarge Surveillance and analysis of Risk Factors

2005 ◽  
Vol 26 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Piret Mitt ◽  
Katrin Lang ◽  
Aira Peri ◽  
Matti Maimets
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Fetal Monitoring ◽  
University Hospital ◽  
Cross Sectional Survey ◽  
Increased Risk ◽  
Multi Method Approach ◽  
Method Approach

AbstractObjectives:To evaluate a multi-method approach to postdischarge surveillance of surgical-site infections (SSIs) and to identify infection rates and risk factors associated with SSI following cesarean section.Design:Cross-sectional survey.Setting:Academic tertiary-care obstetric and gynecology center with 54 beds.Patients:All women who delivered by cesarean section in Tartu University Women's Clinic during 2002.Methods:Infections were identified during hospital stay or by postdischarge survey using a combination of telephone calls, healthcare worker questionnaire, and outpatient medical records review. SSI was diagnosed according to the criteria of the Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System.Results:The multi-method approach gave a follow-up rate of 94.8%. Of 305 patients, 19 (6.2%; 95% confidence interval [CI95)], 3.8-9.6) had SSIs. Forty-two percent of these SSIs were detected during postdischarge surveillance. We found three variables associated with increased risk for developing SSI: internal fetal monitoring (odds ratio [OR], 16.6; CI95, 2.2-125.8; P = .007), chorioamnionitis (OR, 8.8; CI95, 1.1-69.6; P = .04), and surgical wound classes III and IV (OR, 3.8; CI95, 1.2-11.8; P=.02).Conclusions:The high response rate validated the effectiveness of this kind of surveillance method and was most suitable in current circumstances. A challenge exists to decrease the frequency of internal fetal monitoring and to treat chorioamnionitis as soon as possible (Infect Control Hosp Epidemiol 2005;26:449-454).

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