The Influence of Traffic, Area Location, and Other Factors on Operating Room Microbial Load

Abstract

OBJECTIVE To determine how the movement of patients, equipment, materials, staff, and door openings within the operating room (OR) affect microbial loads at various locations within the OR. DESIGN Observation and sampling study. SETTING Academic health center, public hospital. METHODS We first analyzed 27 videotaped procedures to determine the areas in the OR with high and low numbers of people in transit. We then placed air samplers and settle plates in representative locations during 21 procedures in 4 different ORs during 2 different seasons of the year to measure microbial load in colony-forming units (CFU). The temperature and humidity, number of door openings, physical movement, and the number of people in the OR were measured for each procedure. Statistical analysis was conducted using hierarchical regression. RESULTS The microbial load was affected by the time of year that the samples were taken. Both microbial load measured by the air samplers and by settle plates in 1 area of the OR was correlated with the physical movement of people in the same area but not with the number of door openings and the number of people in the OR. CONCLUSIONS Movement in the OR is correlated with the microbial load. Establishing operational guidelines or developing OR layouts that focus on minimizing movement by incorporating desirable internal storage points and workstations can potentially reduce microbial load, thereby potentially reducing surgical site infection risk. Infect Control Hosp Epidemiol 2018;39:391-397.

Surgical Infection Society Guidance for Operative and Peri-Operative Care of Adult Patients Infected by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)

“…During the operation, the use of telephonic or other electronic tools to communicate between team members inside and outside the OR is essential to minimize unnecessary door opening and foot traffic [18]. This will minimize the number of individuals who are potentially exposed, unnecessary consumption of PPE and, in cases of negative-pressure rooms, disruption of the pressure gradient [18,19]. The use of a runner stationed immediately outside the door of the OR can facilitate coordinated delivery of needed equipment or specimen processing.…”

Risk Factors for Prosthetic Joint Infection after Primary Hip Arthroplasty

“…В то же время в Норвегии и Швеции прослеживается тенденция к увеличению риска развития ППИ при использовании бесцементных имплантатов [26]. Не менее дискутабельными остаются вопросы влияния на развитие ППИ ирригации раны, типа шва, опыта хирурга, вентиляции операционного зала [22,27,28]. Исходя из этого, нами была оценена роль основных факторов в развитии ППИ -какой-либо статистически значимой зависимости установлено не было.…”

Surgical site infection: Prevention and management across health-care sectors

“…177 The number of airborne microbial particles in an operating room is proportional to the number of humans present and their level of activity. 178 Each person has been estimated to emit approximately 1000 organisms per minute at rest, increasing to 50,000 per minute during activity as friction of clothing against the skin releases more squames. 179,180 These particles may settle on to instruments or gloved hands or into the wound itself and subsequently result in wound infection.…”