The Effect of Traffic Patterns in the OR on Surgical Site Infections

Pryor, Flavia M.; Messmer, Patricia R.

doi:10.1016/s0001-2092(06)62570-2

Cited by 72 publications

(37 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition to other studies [11,13,16], Young et al [17] reported an increased trend of surgical site infections with an increased rate of OR traffic. In rooms equipped with laminar airflow, the opening and closing of the operating room door disrupts the airflow in close proximity to the patient.…”

Section: Introductionmentioning

confidence: 71%

“…These pathogens have the potential to lead to increased rates of infection. Furthermore, increased OR traffic itself increases the risk of PJI [11,13,16,17]. Our two main objectives were to (1) quantify operating room traffic during both primary and revision THA and TKA, providing a comparison between the two types of procedures, and (2) identify the causes of the traffic with the purpose of developing a strategy to reduce door opening during TJA.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Operating Room Traffic is a Major Concern During Total Joint Arthroplasty

Panahi

Casper

et al. 2012

Clinical Orthopaedics &Amp; Related Research

145

View full text Add to dashboard Cite

Background Periprosthetic joint infection (PJI) is a challenging complication associated with total joint arthroplasty (TJA). Traffic in the operating room (OR) increases bacterial counts in the OR, and may lead to increased rates of infection. Question/purposes Our purposes were to (1) define the incidence of door opening during primary and revision TJA, providing a comparison between the two types of procedures, and (2) identify the causes of door opening in order to develop a strategy to reduce traffic in the operating room. Methods An observer collected data during 80 primary and 36 revision TJAs. Surgeries were performed under vertical, laminar flow. Operating room personnel were unaware of the observer, thus removing bias from traffic. The observer documented the number, reason, and personnel involved in the event of a door opening from time of tray opening to closure of the surgical site.Results The average operating time for primary and revision procedures was 92 and 161 minutes, respectively. Average door openings were 60 in primary cases and 135 in revisions, yielding per minute rates of 0.65 and 0.84, respectively. The circulating nurse and surgical implant representatives constituted the majority of OR traffic. Conclusions Traffic in the OR is a major concern during TJA. Revision cases demonstrated a particularly high rate of traffic. Implementation of strategies, such as storage of instruments and components in the operating room and education of OR personnel, is required to reduce door openings in the OR.

show abstract

Section: Introductionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Operating Room Traffic is a Major Concern During Total Joint Arthroplasty

Panahi

Casper

et al. 2012

Clinical Orthopaedics &Amp; Related Research

145

View full text Add to dashboard Cite

show abstract

“…A greater number of persons in the operating room can increase the rates of surgical site infections from 1.5 to 3.8 (16). Our operating rooms are old and without adequate system of ventilation.…”

Section: Discussionmentioning

confidence: 99%

Surgical Site Infections in Orthopedic Patients: Prospective Cohort Study

et al. 2008

View full text Add to dashboard Cite

Aim To estimate the incidence rate and risk factors of surgical site infections in the orthopedic wards in a major teaching hospital in Serbia.Methods A 6-month prospective cohort study, with 30 days of patient follow-up after surgery, was conducted at the teaching hospital in Belgrade. We collected patients' basic demographic data and data on underlying disease status, surgical procedures, preoperative preparation of patients, and antibiotic prophylaxis. The National Nosocomial Infections Surveillance (NNIS) risk index was computed for each patient. Descriptive and logistic regression analyses were performed to determine risk factors for surgical site infections.Results Assessment of 277 patients after operation revealed surgical site infection in 63 patients. In 3 (4.8%) of them, surgical site infections were detected after hospital discharge. The overall incidence rate of surgical site infections was 22.7% (95% confidence interval [95% CI], 17.5-29.1). The incidence increased from 13.2% in clean wounds to 70.0% in dirty wounds. The rates of surgical site infection for the NNIS risk index classes 0 to 3 were 8.1% (13 of 161), 36.4% (32 of 88), 63.0% (17 of 27), and 100% (1 of 1) (P<0.001; χ 2 test). Multivariate logistic regression analysis identified the following independent risk factors for surgical site infections: greater number of persons in the operating room (odds ratio [OR], 1.28; 95% CI, 1.02-1.60), contaminated or dirty wounds (OR, 12.09; 95% CI, 5.56-26.28), and American Society of Anesthesiologists' (ASA) score >2 (OR, 3.47; 95% CI, 1.51-7.95). In patients who were shaved with a razor, the period of 12 or more hours between shaving and intervention was also an independent risk factor (OR, 2.77; 95% CI, 1.22-6.28).Conclusion There is a high incidence of surgical site infections in orthopedic patients in Serbia in comparison with developed countries and some developing countries. Points for intervention could be reduction of personnel during surgery, better treatment of wounds, decreasing ASA score, and reduction of the time between surgical site shaving and the intervention.

show abstract

“…However, despite improvements in preoperative and perioperative methods to reduce infection [5,9,10,33,38,47,50,54], its incidence after TKA remains around 1% to 2% in large studies [29,30]. The revision TKA burden in the United States accounted for 46,000 procedures during 2005 [28], with some estimates that up to 25% of revisions are due to infection [3].…”

Section: Introductionmentioning

confidence: 99%