Forced Air Contamination Risk in the OR

Abstract

BACKGROUND Patient warming to maintain perioperative normothermia is known to reduce temperature-related complications, improve overall postoperative results and shorten patient hospital stays. Forced-air warming (FAW) devices—commonly used in operating theaters—can introduce bacteria into the surgical environment, increasing both possible contamination and attributable Surgical Site Infection (SSI) risks. A number of published studies point toward a surface-component contamination and tissue-air risk connection. This investigation was designed to seek new data regarding any FAW-bacteria correlation in an effort to both better understand possible, associated, FAW-use risks and contribute to infection-control protocols that more effectively assist in mitigating or diminishing consequential Healthcare Associated Infection (HAI) risk. METHODS A total of 320 surface and air samples were collected and cultured from in and around 35 unique FAW devices actively in-use in operating room (OR) settings at three hospital facilities in an associated acute-care system. Surface samples were taken from multiple FAW device points: the internal hose surface, the proximal hose end and the distal hose end. Each retrieved sample was bagged, plated and incubated under sterile procedures. RESULTS The results show that 24.4 percent (78 of 320) of all samples collected were at higher than maximum acceptable Colony Forming Unit (CFU) pathogens levels. Forty-two and half, 42.5, percent (136 of 320) of all samples were at higher than minimum acceptable CFU levels; 37.2 percent (119 of 320) were equipment samples; 5.3 percent (17 of 320) were air samples. Study results also identified a correlation of positive airborne samples for instances that had high-pathogen contamination in the warmer-temperature components, resulting in a possible increased patient infection risk and possible attributable SSI as primary concerns. CONCLUSIONS FAW device-component contamination may be a risk in the OR. Cross-contamination of the environment remains a risk as well. A reduction in surface and airborne CFUs may positively reduce SSI and HAI infection risk.