scholarly journals Simulated operating room aerodynamics to improve air quality and prevent surgical site infections

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Messina ◽  
G Spataro ◽  
M Tarroni ◽  
G Cevenini
Keyword(s):  
Air Quality ◽  
Operating Room ◽  
Ventilation System ◽  
Surgical Site Infections ◽  
Simulation Software ◽  
University Hospital ◽  
Operating Table ◽  
Air Filtration ◽  
Air System ◽  
Air Flows

Abstract Background Proper operating room (OR) ventilation and air filtration are important measures to prevent infection of the surgical site and consequently reduce hospital stay and healthcare costs. In order to identify how changes in the air system can affect air quality, tailor-made researches need to be conducted in ORs. The aim of the study is to verify how a mobile air filtration system can affect the air quality of ORs when placed in different positions. Methods This is a descriptive study conducted during April and May 2018 in the University Hospital of Siena, Italy. We measured air flows through the vents of both the OR air system and a mobile novel air system unit, which includes a patented crystalline ultraviolet C reactor and an HEPA filter. Using a CAD 3D simulation software (SolidWorks 2017) the air flows interactions were simulated in the replicated OR. Results The device influenced the original airflows generated by the integrated OR ventilation system. Simulations have shown that when the device is positioned close to the wall with its intake beside the entrance and its outlet towards the operating table, air from outside can enter the room because the air intake from the device prevails over the internal pressure of the OR, increasing contamination. If the device is placed near the OR centre with its suction towards the operating table and its outlet towards the OR entrance, if the door is opened, airflows towards the outside of the room prevail, improving ability to retain outgoing contaminants. Conclusions The different positioning of mobile devices that generate clean air flows within ORs can have a significant impact on aerodynamics, which can turn can affect critical aspects of the surgical outcome. In order to achieve an effective device placement and orientation, OR-specific environmental measurements should be carried out. Key messages Movable devices may help boosting the performance of air systems in operating rooms. Every operating room needs a specific study in order to obtain the best profit.

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 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.

Shutting Down Operating Theater Ventilation When the Theater Is Not in Use: Infection Control and Environmental Aspects

2003 ◽  
Vol 24 (8) ◽  
pp. 596-600 ◽  
Author(s):  
Markus Dettenkofer ◽  
M. Scherrer ◽  
V. Hoch ◽  
H. Glaser ◽  
G. Schwarzer ◽  
...  
Keyword(s):  
Ventilation System ◽  
Cost Savings ◽  
German Society ◽  
University Hospital ◽  
Operating Table ◽  
Particle Count ◽  
High Particle ◽  
Air Supply ◽  
Colony Forming Units ◽  
Air Conditioning Systems

AbstractObjective:In hospital operating rooms (ORs), specially conditioned air is supplied to protect patients from airborne agents that may cause infections. This study investigated whether it is hygienically safe to shut down the air supply at night if measures are taken to ensure a timely restart before surgery is performed.Design:Experimental study.Setting:Neurosurgical OR of a German university hospital.Methods:The ventilation system was switched off and restarted after 10 hours. Particles suspended in the air near the operating table were counted, OR temperature was measured, and settle plates were exposed and incubated.Results:In 13 investigations, a median of 1.3 × 104 particles 0.5 μm/m3 or greater (range, 5.8 × 103 to 1.1 × 105) were documented immediately after restart in the morning. After 10 minutes and subsequently, no test showed a particle count exceeding the threshold limit of 1.0 × 104 particles 0.5 μm/m3 or greater recommended by the German Society of Hygiene and Microbiology. Only a few colony-forming units (CFU) were detected per settle plate (median, 0 CFU/60 cm2; range, 0 to 8) and OR temperatures quickly reached normal levels.Conclusions:Shutting down OR ventilation during off-duty periods does not appear to result in an unacceptably high particle count or microbial contamination of the OR air shortly after the system is restarted. Because substantial energy and cost savings are likely, this should be considered in hygienically safe heating, ventilation, and air conditioning systems. However, normal ventilation should be established at least 30 minutes before surgical activity.

scholarly journals Enhancement of Airborne Particles Removal in a Hospital Operating Room

2019 ◽  
Vol 16 (4) ◽  
pp. 7447-7463
Author(s):  
K. Y. Wong ◽  
H. M. Kamar ◽  
N. Kamsah
Keyword(s):  
Operating Room ◽  
Numerical Study ◽  
Ventilation System ◽  
Airborne Particles ◽  
Operating Table ◽  
Particle Removal ◽  
Discrete Phase Model ◽  
Air Velocity ◽  
Air Supply ◽  
Discrete Phase

This article presents the results of a numerical study to examine the transport of particles in an operating room equipped with an Econoclean ventilation system. Its aims are to reduce the number of particles falling onto the operating table. A simplified CFD model of the operating room was developed and validated based on the measured air velocity distribution. An SST k-ω turbulent flow model was used to simulate the airflow, while a discrete phase model was used to simulate the movement of the airborne particles. The effects of the standing posture of the surgical staff on the settlement of the particles on the operating table were examined. Results show that under the present ventilation system, when the surgical staff bend forward at an angle of 45°,  the number of airborne particles that tend to fall onto the operating table increased by 1.4-fold. Adding an exhaust grille to the operating room does not have any significant effects on the distribution of the airborne particles. However, when a larger air supply diffuser is also used, the number of airborne particles that settled on the operating table was reduced 4-fold. More airborne particles are transported towards the exhaust grilles, and more airborne particles accumulate below the operating table. The present study shows that the usage of large air supply diffuser in the operating room is capable of reducing the number of airborne particles fall onto the operating table. Also, it enhances the efficiency of airborne particle removal.

scholarly journals Operating room architecture is not a risk factor for surgical site infections

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thorsten Jentzsch ◽  
Lucas Kutschke ◽  
Patrick O. Zingg ◽  
Mazda Farshad
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Operating Room ◽  
Broad Spectrum ◽  
Surgical Site Infections ◽  
The Body ◽  
University Hospital ◽  
Asa Classification ◽  
Open Plan ◽  
And Gender

AbstractSurgical site infection (SSI) may cause a substantial burden for patients and healthcare systems. A potential risk of different architectures of the operating room for SSI is yet unknown and was subject of this study. This observational cohort study was performed in a university hospital and evaluated patients, who underwent a broad spectrum of orthopedic surgeries in 2016 (open-plan operating room architecture) versus (vs) 2017 (closed-plan operating room architecture). Patients, who underwent surgery in the transition time period from the open-plan to the closed-plan operating room architecture and those, who were treated e.g. for osteomyelitis as index procedure were excluded. The primary outcome was revision surgery for early SSI within 30 (superficial) or 90 (deep or organ/space) days of surgery. Age, gender, American society of anesthesiologists (ASA) classification, and the body mass index (BMI) were considered as potential interacting factors in a logistic regression analysis. The incidence of revisions for SSI was 0.6 percent (%) (n = 45) in the 7'740 included surgical cases (mean age of 52 (standard deviation (SD) 19) years; n = 3'835 (50%) females). There was no difference in incidences of revision for SSI in the open- vs closed-plan operating room architecture (0.5% vs 0.7%; adjusted odds ratio (OR) = 1.34 (95% confidence interval (CI) 0.72–2.49, P = 0.35)). Age and gender were not a risk factor for revision for SSI. However, ASA classification and BMI were identified as risk factors for the incidence of revision for SSI (OR = 1.92 (95% CI 1.16- 3.18, P = 0.01) and OR = 1.05 (95% CI 1.00–1.11, P = 0.05)). The overall incidence of revisions for early SSI after a broad spectrum of orthopedic surgeries was relatively low (0.6%) and independent from the operating room architecture. An increase in ASA classification and possibly BMI, however, were identified as independent risk factors for revision for SSI.

scholarly journals Determining knowledge and administration of nurses in preventing surgical site infections

2019 ◽  
Vol 6 (10) ◽  
pp. 230-234
Author(s):  
Yelda Candan Dönmez ◽  
Pelin Sarı
Keyword(s):  
Data Collection ◽  
Operating Room ◽  
Surgical Site Infections ◽  
Study Data ◽  
University Hospital ◽  
Average Score ◽  
Face To Face ◽  
Clinical Nurses ◽  
Surgical Units ◽  
Operating Room Nurses

Objective: This study was conducted to define the knowledge and administrations of nurses working in surgical clinics for the prevention of surgical site infections. Material and Methods: The research sample consisted of 199 nurses who were working in surgical clinics and operating rooms of a university hospital between 02 October and 29 December 2017 and who were volunteers to participate in the study and met the limitations of the study. Data were collected by the researchers through face to face interviews with the nurses included in the study. Data collection tools were developed by the researchers in line with the literature. Sociodemographic characteristics information form, SSI Information Questionnaire and Practice Evaluation Form of Nurses in Preventing SSI were used as data collection tools. Results: The mean age of nurses participating in the study was 35.2 ± 6.2 years, 97.5% of them were women, 89.4% of them were graduate's degree, 36.2% of them were working in surgical units between 13-60 months, 58.3% in the last two years, 48.7% of them have received training in the site of surgical site infections in the last two years. It was found that 62.3% of the nurses' knowledge status was “moderate”. The average score of the practice statements answered by the clinical nurses participated in the research was found out to be 65,16±6,11, by the operating room nurses participated in the research was found out to be 64,09±6,93. It was found that there was a statistically significant relationship between the training status of the operating room nurses participating in the study and their administration scores (p <0.05). Conclusion: Results obtained from the study; the knowledge and administration scores of the nurses who were trained in CAE were found to be higher.

Numerical and Experimental Modeling of Indoor Air Quality Inside a Conditioned Space with Mechanical Ventilation and DX-Air Conditioner

2020 ◽  
Vol 38 (9A) ◽  
pp. 1257-1275
Author(s):  
Wisam M. Mareed ◽  
Hasanen M. Hussen
Keyword(s):  
Air Quality ◽  
Indoor Air Quality ◽  
Indoor Air ◽  
Ventilation System ◽  
Thermal Conditions ◽  
Airflow Rate ◽  
Air Conditioner ◽  
Breathing Zone ◽  
Lecture Room ◽  
Ventilation Performance

 Elevated CO2 rates in a building affect the health of the occupant. This paper deals with an experimental and numerical analysis conducted in a full-scale test room located in the Department of Mechanical Engineering at the University of Technology. The experiments and CFD were conducted for analyzing ventilation performance. It is a study on the effect of the discharge airflow rate of the ceiling type air-conditioner on ventilation performance in the lecture room with the mixing ventilation. Most obtained findings show that database and questionnaires analyzed prefer heights between 0.2 m to 1.2 m in the middle of an occupied zone and breathing zone height of between 0.75 m to 1.8 given in the literature surveyed. It is noticed the mismatch of internal conditions with thermal comfort, and indoor air quality recommended by [ASHRAE Standard 62, ANSI / ASHRAE Standard 55-2010]. CFD simulations have been carried to provide insights on the indoor air quality and comfort conditions throughout the classroom. Particle concentrations, thermal conditions, and modified ventilation system solutions are reported.

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