Operating theatre ventilation systems and microbial air contamination in total joint replacement surgery: results of the GISIO-ISChIA study

Umberto Moscato, A. Agodi, F. Auxilia, M. Barchitta, M. L. Cristina, D. D'Alessandro, I. Mura, M. Nobile, C. Pasquarella, Sergio Avondo, Patrizia Bellocchi, Rosario Canino, Claudio Capozzi, Renata Casarin, Massimo Cavasin, Pietro Contegiacomo, Maria Grazia Deriu, Francesco Roberto Evola, Pasquale Farsetti, Annise GrandiDanilo Guareschi, Anna Maria Longhitano, Gianfranco Longo, Renzo Malatesta, Pietro Marenghi, Francesco Marras, Alessandra Maso, Anna Rita Mattaliano, Maria Teresa Montella, Paola Navone, Maria Antonietta Romeo, Flora Rossi, Maria Ruffino, Carmela Santangelo, Marina Sartini, Giuseppe Sessa, Stefano Tardivo, Paolo Tranquilli Leali, Maria Valeria Torregrossa, Pietro Vitali

Risultato della ricerca: Contributo in rivistaArticolo in rivista

38 Citazioni (Scopus)

Abstract

BACKGROUND: Recent studies have shown a higher rate of surgical site infections in hip prosthesis implantation using unidirectional airflow ventilation compared with turbulent ventilation. However, these studies did not measure the air microbial quality of operating theatres (OTs), and assumed it to be compliant with the recommended standards for this ventilation technique. AIM: To evaluate airborne microbial contamination in OTs during hip and knee replacement surgery, and compare the findings with values recommended for joint replacement surgery. METHODS: Air samplings were performed in 28 OTs supplied with unidirectional, turbulent and mixed airflow ventilation. Samples were collected using passive sampling to determine the index of microbial air contamination (IMA). Active sampling was also performed in some of the OTs. The average number of people in the OT and the number of door openings during the sampling period were recorded. FINDINGS: In total, 1228 elective prosthesis procedures (60.1% hip and 39.9% knee) were included in this study. Of passive samplings performed during surgical activity in unidirectional airflow ventilation OTs (U-OTs) and mixed airflow OTs (M-OTs), 58.9% and 87.6% had IMA values >2, respectively. Of samplings performed during surgical activity in turbulent airflow OTs (T-OTs) and in turbulent airflow OTs with the surgical team wearing Steri-Shield Turbo Helmets (TH-OTs), 8.6% and 60% had IMA values ≤ 2, respectively. Positive correlation was found between IMA values and the number of people in the OT and the number of door openings (P < 0.001). In addition, correlation was found between active and passive sampling (P < 0.001). CONCLUSION: These findings challenge the belief that unidirectional systems always provide acceptable airborne bacterial counts.
Lingua originaleEnglish
pagine (da-a)213-219
Numero di pagine7
RivistaTHE JOURNAL OF HOSPITAL INFECTION
Volume90
DOI
Stato di pubblicazionePubblicato - 2015

Keywords

  • Air microbial contamination
  • Heating, ventilation and air conditioning
  • Operating theatre
  • Total joint replacement

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