Air cleanliness in operating theatres (OTs) is an important factor for preserving the health of both the patient and the medical staff. Particle contamination in OTs depends mainly on the surgery process, ventilation principle, personnel clothing systems and working routines. In many open surgical operations, electrosurgical tools (ESTs) are used for tissue cauterization. ESTs generate a significant airborne contamination, as surgical smoke. Surgical smoke is a work environment quality problem. Ordinary surgical masks and OT ventilation systems are inadequate to control this problem. This research work is based on numerous monitoring campaigns of ultrafine particle concentrations in OTs, equipped with upward displacement ventilation or with a downward unidirectional airflow system. Measurements performed during ten real surgeries highlight that the use of ESTs generates a quite sharp and relevant increase of particle concentration in the surgical area as well within the entire OT area. The measured contamination level in the OTs are linked to surgical operation, ventilation principle, and ESTs used. A better knowledge of airborne contamination is crucial for limiting the personnel’s exposure to surgical smoke. Research results highlight that downward unidirectional OTs can give better conditions for adequate ventilation and contaminant removal performances than OTs equipped with upward displacement ventilation systems.
Air cleanliness is a crucial factor in operating theatres (OTs), where the health of patients and staff must be preserved by controlling air contamination. Particular attention must be paid to ultrafine particles (UFPs) size range, generated for instance by electrosurgical instruments (ESTs). OT contamination is also affected by ventilation systems, medical staff and their gowning system, staff routines, instruments, etc. This comparative study is based on experimental measurements of airborne microbial contamination and UFPs carried out during real ongoing surgeries in two OTs equipped with upward displacement ventilation (UWD) and hybrid ventilation, with unidirectional airflow on the operating table and peripheral mixing (UDAF+Mixing) ventilation systems. Airborne contamination concentration at the exit grilles has been analyzed as function of four different surgical phases normally performed during an operation. Results highlight that airborne contamination is influenced by the activities carried out during the surgical phases. EST usage affects the contamination level more than staff size during operation observed. Colony forming unit (CFU) values in the protected area close to the patient’s wound are influenced more by the type of ventilation system than by surgical phases. CFU values decrease by 18 to 50 times from the UWD system to the hybrid one. The large airflow volumes supply together with high air velocities in OTs equipped with UDAF+Mixing systems guarantee a better and a safer airborne contamination control for patients and medical team in comparison with UWD systems.
The number of airborne bacteria-carrying particles in the operating room is considered an indicator of the risk of infections to the patient undergoing surgery. When the supply air in the operating room is HEPA-filtered, the main source of microorganisms is people (patient and staff). The filtration efficacy of the fabric in operating clothing systems plays an important role. The design of the clothing systems also affects the number of particles emitted from people into the air of the operating room. In ultraclean operating rooms, the selection of clothing systems for the operating team should be considered in terms of patient safety. Examples of clothing systems evaluated in operating rooms will be presented. The predicted influence of different clothing systems in the operating room will be discussed.
A chamber to expose subjects to birch pollen has been installed at the Allergy Center, Sahlgrenska University Hospital, Göteborg, Sweden. The aims of the investiga tions planned for this chamber are mainly to determine the amount of pollen and the exposure time that can give rise to allergic symptoms. In this paper, results from per formance tests of the chamber and its ventilation system are presented. Further, some results are given from ini tial tests with pollen.
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