Abstract
Surgical staff behavior in operating theatres is one of the factors associated with indoor air quality and surgical site infection risk. The aim of this study was to apply an approach including microbiological, particle, and microclimate parameters during two simulated surgical hip arthroplasties to evaluate the influence of staff behavior on indoor air quality. During the first hip arthroplasty, the surgical team behaved correctly, but in the second operation, behavioral recommendations were not respected. Microbiological contamination was evaluated by active and passive methods. The air velocity, humidity, temperature, and CO2 concentration were also monitored. The highest levels of microbial and particle contamination, as well as the highest variation in the microclimate parameter, were recorded during the surgical operation where the surgical team behaved “incorrectly”. Turbulent air flow ventilation systems appeared more efficient than in the past and very low air microbial contamination was reached when behavior was correct. Therefore, adherence to behavioral recommendations in operating theatres is essential to not undermine the effectiveness of the heating, ventilation, and air conditioning systems and employed resources.
Highlights
Surgical site infections (SSIs) following total joint replacement surgery make up the most feared complication, presenting a significant burden in terms of patient morbidity and additional related costs [1]
This study study describes describes an an approach approach of of evaluating evaluating biological, biological, particle, particle, and and microclimatic microclimatic air air quality quality in conventional operating theatres, which was applied during two simulated hip arthroplasties in conventional operating theatres, which was applied during two simulated hip arthroplasties in in two two different different conditions conditions of of surgical surgical staff staff behavior
Our study shows the negative influence of the surgical team’s incorrect behavior on operating theatre microbial and particle air contamination and microclimatic parameters
Summary
Surgical site infections (SSIs) following total joint replacement surgery make up the most feared complication, presenting a significant burden in terms of patient morbidity and additional related costs [1]. Many factors increase the risk of SSIs, including patient-related, procedural-related, and management-related factors [1]. In order to preserve the indoor air quality provided by heating, ventilation, and air conditioning (HVAC), reducing operator movement in the operating theatres during surgical activity is recommended, e.g., keeping operating theatre doors closed, except as needed for passage of equipment, personnel, and the patient, limiting the number of personnel entering the operating theatre to those necessary, and minimize personnel traffic during operations [1,2,3,4]. Public Health 2020, 17, 452; doi:10.3390/ijerph17020452 www.mdpi.com/journal/ijerph
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