Conditions for air cleanliness in a unidirectional airflow ventilation during orthopaedic joint replacement procedures

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES

Journal of Hospital Infection Pub Date : 2025-05-19 DOI:10.1016/j.jhin.2025.05.004

I-L. Böregård , S. Bringman , C. Leo Swenne , A-C. von Vogelsang

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引用次数: 0

Abstract

Background

Microbiological air contamination in the operating room (OR) is associated with the risk of surgical site infections (SSIs) after joint replacement procedures. Recommendations define the level of microbiological air cleanliness by the number of colony-forming units (cfu) in an OR. Airborne micro-organisms originate from the staff and unidirectional airflow (UDAF) ventilation is effective in the OR, providing filtered air to create ultraclean zones.

Aim

To evaluate the air cleanliness in the demarcation zone during joint replacement procedures and to describe the limitations for optimal air cleanliness in UDAF ventilation.

Methods

In a cross-sectional design, cfu were measured using active air sampling in an OR with UDAF. Comparative measures were taken between demarcation and outer zone, supplemented by observations of staff numbers, traffic flow and movements.

Findings

A total of 166 samples were collected during 20 arthroplasty procedures. There were significantly more cfu in the outer zone than in the demarcation zone (P < 0.001). The only significant predictor associated with higher cfu counts was the number of persons in the outer zone (odds ratio: 2.566; 95% confidence interval: 1.306–5.044; P = 0.006). Observations associated with higher cfu counts were method- or organization-related.

Conclusion

Air cleanliness in UDAF ventilation was better in the demarcation zone compared to the outer zone, and the number of persons in the outer zone was associated with decreased air cleanliness. Intraoperative movements could cause higher cfu counts in the demarcation zone, but further studies are needed to evaluate the consequences of staff movements.

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骨科关节置换过程中单向气流通风的空气洁净度条件。

背景：手术室（OR）的微生物空气污染与关节置换术后手术部位感染（ssi）的风险相关。建议通过手术室中菌落形成单位（cfu）的数量来定义微生物空气清洁度水平。空气中的微生物来自工作人员，单向气流（UDAF）通风在手术室是有效的，提供过滤空气来创建超洁净区。目的：评估关节置换过程中划定区域的空气清洁度，并描述UDAF通风中最佳空气清洁度的限制。方法：采用横断面设计，在装有UDAF的手术室中使用主动空气采样测量cfu。在边界和外区之间采取了比较措施，并辅以对工作人员人数、交通流量和移动的观察。结果：在20个关节置换术中共收集了166个样本。外区菌群明显多于界域菌群（P < 0.001）。唯一与较高cfu计数相关的显著预测因子是外区人数(优势比：2.566；95%置信区间：1.306-5.044；P = 0.006)。与较高cfu计数相关的观察结果与方法或组织有关。结论：UDAF通风分界区空气洁净度好于外区，外区人数与空气洁净度下降相关。术中移动可导致分界区cfu计数增高，但需要进一步研究来评估人员移动的后果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.