TY - JOUR
T1 - Operating theatre ventilation systems and microbial air contamination in total joint replacement surgery
T2 - Results of the GISIO-ISChIA study
AU - Agodi, A.
AU - Auxilia, F.
AU - Barchitta, M.
AU - Cristina, M. L.
AU - D'Alessandro, D.
AU - Mura, I.
AU - Nobile, M.
AU - Pasquarella, C.
AU - Avondo, Sergio
AU - Bellocchi, Patrizia
AU - Canino, Rosario
AU - Capozzi, Claudio
AU - Casarin, Renata
AU - Cavasin, Massimo
AU - Contegiacomo, Pietro
AU - Deriu, Maria Grazia
AU - Evola, Francesco Roberto
AU - Farsetti, Pasquale
AU - Grandi, Annise
AU - Guareschi, Danilo
AU - Longhitano, Anna Maria
AU - Longo, Gianfranco
AU - Malatesta, Renzo
AU - Marenghi, Pietro
AU - Marras, Francesco
AU - Maso, Alessandra
AU - Mattaliano, Anna Rita
AU - Montella, Maria Teresa
AU - Moscato, Umberto
AU - Navone, Paola
AU - Romeo, Maria Antonietta
AU - Rossi, Flora
AU - Ruffino, Maria
AU - Santangelo, Carmela
AU - Sartini, Marina
AU - Sessa, Giuseppe
AU - Tardivo, Stefano
AU - Leali, Paolo Tranquilli
AU - Torregrossa, Maria Valeria
AU - Vitali, Pietro
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Background: Recent studies have shown a higher rate of surgical site infections in hip prosthesis implantation using unidirectional airflow ventilation compared with turbulent ventilation. However, these studies did not measure the air microbial quality of operating theatres (OTs), and assumed it to be compliant with the recommended standards for this ventilation technique. Aim: To evaluate airborne microbial contamination in OTs during hip and knee replacement surgery, and compare the findings with values recommended for joint replacement surgery. Methods: Air samplings were performed in 28 OTs supplied with unidirectional, turbulent and mixed airflow ventilation. Samples were collected using passive sampling to determine the index of microbial air contamination (IMA). Active sampling was also performed in some of the OTs. The average number of people in the OT and the number of door openings during the sampling period were recorded. Findings: In total, 1228 elective prosthesis procedures (60.1% hip and 39.9% knee) were included in this study. Of passive samplings performed during surgical activity in unidirectional airflow ventilation OTs (U-OTs) and mixed airflow OTs (M-OTs), 58.9% and 87.6% had IMA values >2, respectively. Of samplings performed during surgical activity in turbulent airflow OTs (T-OTs) and in turbulent airflow OTs with the surgical team wearing Steri-Shield Turbo Helmets (TH-OTs), 8.6% and 60% had IMA values ≤2, respectively. Positive correlation was found between IMA values and the number of people in the OT and the number of door openings (P
AB - Background: Recent studies have shown a higher rate of surgical site infections in hip prosthesis implantation using unidirectional airflow ventilation compared with turbulent ventilation. However, these studies did not measure the air microbial quality of operating theatres (OTs), and assumed it to be compliant with the recommended standards for this ventilation technique. Aim: To evaluate airborne microbial contamination in OTs during hip and knee replacement surgery, and compare the findings with values recommended for joint replacement surgery. Methods: Air samplings were performed in 28 OTs supplied with unidirectional, turbulent and mixed airflow ventilation. Samples were collected using passive sampling to determine the index of microbial air contamination (IMA). Active sampling was also performed in some of the OTs. The average number of people in the OT and the number of door openings during the sampling period were recorded. Findings: In total, 1228 elective prosthesis procedures (60.1% hip and 39.9% knee) were included in this study. Of passive samplings performed during surgical activity in unidirectional airflow ventilation OTs (U-OTs) and mixed airflow OTs (M-OTs), 58.9% and 87.6% had IMA values >2, respectively. Of samplings performed during surgical activity in turbulent airflow OTs (T-OTs) and in turbulent airflow OTs with the surgical team wearing Steri-Shield Turbo Helmets (TH-OTs), 8.6% and 60% had IMA values ≤2, respectively. Positive correlation was found between IMA values and the number of people in the OT and the number of door openings (P
KW - Air microbial contamination
KW - Heating, ventilation and air conditioning
KW - Operating theatre
KW - Total joint replacement
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U2 - 10.1016/j.jhin.2015.02.014
DO - 10.1016/j.jhin.2015.02.014
M3 - Article
C2 - 25997801
AN - SCOPUS:84930571866
VL - 90
SP - 213
EP - 219
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
SN - 0195-6701
IS - 3
ER -