(f) Qiaojie Wang, MD; Chi Xu, MD; Karan Goswami, MD, MRCS; et al (2020)
Association of Laminar Airflow During Primary Total Joint Arthroplasty With Periprosthetic Joint Infection
This study suggests that the use of LAF in the operating room was not associated with a reduced incidence of PJI after primary total joint arthroplasty. With an appropriate perioperative protocol for infection prevention, LAF does not seem to play a protective role in PJI prevention. Patients underwent total joint arthroplasty in operating rooms equipped with either LAF or turbulent airflow.
(e) Charles E. Edmiston Jr, PhD, et al. (2005)
Modern operating rooms are considered to be aseptic environments. The use of surgical mask, frequent air exchanges, and architectural barriers are used to reduce airborne microbial populations. Breaks in surgical technique, host contamination, or hematogenous seeding are suggested as causal factors in these infections. Gram-positive staphylococcal isolates were frequently isolated from air samples obtained throughout the operating room, including areas adjacent to the operative field. Nasopharyngeal shedding from person participating in the operation was identified as the source of many of these airborne contaminants. Failure of the traditional surgical mask to prevent microbial shedding is likely associated with an increased risk of perioperative contamination of biomedical implants, especially in procedures lasting longer than 90 minutes.
(d) Wang, C (2019)
Ventilation performance in operating rooms: A numerical assessment, Doctoral Thesis, KTH Royal Institute of Technology
CFD simulations on supercomputers show that door openings have a detrimental impact on the microbiological cleanliness of the OR. The simulations also show that the choice of ventilation impacts the resilience towards this kind of disturbances.
(c) Andersson, A.E., Bergh, I., Karlsson, J., Eriksson, B.I., & Nilsson, K. (2012)
Traffic flow in the operating room: An explorative and descriptive study on air quality during orthopedic trauma implant surgery. American Journal of Infection Control, 40(8), 750-755.
The study by Andersson et al including 30 orthopedic procedures investigated the air quality in terms of cfu/m3 during orthopedic trauma surgery in a conventionally ventilated operating room. The effect of traffic flow and number of surgical staff present in the operating room on the air contamination rate was evaluated in the vicinity of the surgical wound. The study concludes that traffic flow has a strong negative impact on the operating room environment and reducing traffic flow is an important measure to prevent surgical site infections. A weaker yet still positive correlation between the number of people present and airborne bacterial count was also found.
(b) Benediktsdóttir, E. & Kolstad, K. (1984)
Bacteria found on skin scales are either anaerobic, meaning that they do not require oxygen to survive and grow, or aerobic which in contrast implies that they require an oxygenated environment. The contamination of clean surgical wounds with anaerobic and aerobic bacteria was studied in 52 hip operations by Benediktsdóttir and Kolstad. Anaerobic bacteria was found account for about 30% of the total number of bacteria present in the air inside an operating room on average. Those have the ability to survive long enough in the air to be viable once they reach the surgical wound.
(a) Noble, W.C. (1975)
Noble summarizes in his review article that each person sheds around 10 000 skin particles per minute into the air when he or she walks. Approximately 10% of these are estimated to carry bacteria. Moreover, a person is estimated to release more than 107 skin particles each day.
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An extensive list of all scientific literature – in total 45 pieces – that supports Opragon is available on request using the download button below.
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