Comparison of three distinct clean air suits to decrease the bacterial load in the operating room: An observational study

被引:11
作者
Kasina P. [1 ]
Tammelin A. [2 ]
Blomfeldt A.-M. [1 ]
Ljungqvist B. [3 ]
Reinmüller B. [3 ]
Ottosson C. [1 ]
机构
[1] Karolinska Institutet, Södersjukhuset, Department of Clinical Science and Education, Orthopaedic Unit, Stockholm
[2] Karolinska Institutet, Department of Medicine, Solna (MedS), Unit of Infectious Diseases, Stockholm
[3] Chalmers University of Technology, Department of Energy and Environment, Division of Building Services Engineering, Göteborg
关键词
Air-borne bacteria; Operating room; Orthopaedic surgery; Surgical clothing; Ventilation;
D O I
10.1186/s13037-015-0091-4
中图分类号
学科分类号
摘要
Background: Lowering air-borne bacteria counts in the operating room is essential in prevention of surgical site infections in orthopaedic joint replacement surgery. This is mainly achieved by decreasing bacteria counts through dilution, with appropriate ventilation and by limiting the bacteria carrying skin particles, predominantly shed by the personnel. The aim of this study was to investigate if a single use polypropylene clothing system or a reusable polyester clothing system could offer similar air quality in the operating room as a mobile laminar airflow device-assisted reusable cotton/polyester clothing system. Methods: Prospective observational study design, comparing the performance of three Clean Air Suits by measuring Colony Forming Units (CFU)/m3 of air during elective hip and knee arthroplasties, performed at a large university-affiliated hospital. The amount of CFU/m3 of air was measured during 37 operations of which 13 were performed with staff dressed in scrub suits made of a reusable mixed material (69 % cotton, 30 % polyester, 1 % carbon fibre) accompanied by two mobile laminar airflow units. During 24 procedures no mobile laminar airflow units were used, 13 with staff using a reusable olefin fabric clothing (woven polypropylene) and 11 with staff dressed in single-use suits (non-woven spunbonded polypropylene). Air from the operating field was sampled through a filter, by a Sartorius MD8, and bacterial colonies were counted after incubation. There were 6-8 measurements from each procedure, in total 244 measurements. Statistical analysis was performed by Mann-Whitney U-test. Results: The single-use polypropylene suit reduced the amount of CFU/m3 to a significantly lower level than both other clothing systems. Conclusion: Single-use polypropylene clothing systems can replace mobile laminar airflow unit-assisted reusable mixed material-clothing systems. Measurements in standardized laboratory settings can only serve as guidelines as environments in real operation settings present a much more difficult challenge. © 2016 Kasina et al.
引用
收藏
相关论文
共 16 条
[1]  
Sundberg M., Lindgren L., W-Dahl A., Robertsson O., (2014)
[2]  
Garellick G., Karrholm J., Lindahl H., Malchau H., Rogmark C., Rolfson O., (2013)
[3]  
Andersson A.E., Bergh I., Karlsson J., Nilsson K., Patients' experiences of acquiring a deep surgical site infection: An interview study, Am J Infect Control, 38, pp. 711-717, (2010)
[4]  
Zmistowski B., Karam J.A., Durinka J.B., Casper D.S., Parvizi J., Periprosthetic joint infection increases the risk of One-year mortality, J Bone Joint Surg Am, 95A, pp. 2177-2184, (2013)
[5]  
Bozic K.J., Ries M.D., The impact of infection after total hip arthroplasty on hospital and surgeon resource utilization, J. Bone Joint Surg.-Am, 87A, pp. 1746-1751, (2005)
[6]  
Charnley J., Eftekhar N., Postoperative infection in total prosthetic replacement arthroplasty of the hip-joint. With special reference to the bacterial content of the air of the operating room, Br. J. Surg, 56, pp. 641-649, (1969)
[7]  
Lidwell O.M., Lowbury E.J.L., Whyte W., Blowers R., Stanley S.J., Lowe D., Airborne contamination of wounds in joint replacement operations - the relationship to sepsis rates, J Hosp Infect, 4, pp. 111-131, (1983)
[8]  
Lahmer A., Lehnhardt M., Steinau H.U., Hirsch T., Hubert H., Fischer S., Et al., Bacterial burden in the operating room: impact of airflow systems, Am. J. Infect. Control, 40, pp. E228-E232, (2012)
[9]  
Tammelin A., Hambraeus A., Stahle E., Routes and sources of staphylococcus aureus transmitted to the surgical wound during cardiothoracic surgery: possibility of preventing wound contamination by use of special scrub suits, Infect Control Hosp Epidemiol, 22, pp. 338-346, (2001)
[10]  
Panatto D., Gasparini R., Orlando P., Cristina M.L., Spagnolo A.M., Sartini M., Et al., Can particulate Air sampling predict microbial load in operating theatres for arthroplasty?, PLoS One, 7, (2012)