INTRODUCTION: The importance of ultraclean air in reducing deep infection was studied by Charnley who showed that the rate decreased as the airborne bacterial load was reduced. The effectiveness was shown in a large Medical Research Council (MRC) trial, but registry data have not shown a consistent benefit. Because we treat patients with rheumatoid arthritis, we decided to look at our theatre air quality. METHODS: In phase 1 we monitored air quality using settle plates, exposed for one hour after the incision, on the instrument trolleys in a joint replacement theatre. In phase 1 the scrub person did not wear a body exhaust system. In phase 2 all three staff used a body exhaust system, and we played close attention to the orientation and position of the surgical lights and trolleys. RESULTS: In phase 1 we grew 0.24 colonies/plate/hour in the ultraclean zone, which is comparable to the Charnley trial findings. In the second phase we grew 0.03 colonies/plate/hour (p<0.001). When plates were placed on the trolleys in controlled positions there was a tendency for the colonies to appear on the corners of the trolleys at the edge of the clean zone (NS). DISCUSSION: The study showed that in phase 1 colony counts comparable to the original Charnley studies were achieved. Colony counts of 0.03 colonies/plate/hour can be achieved in contemporary practice, with all team members using body exhausts.
INTRODUCTION: The importance of ultraclean air in reducing deep infection was studied by Charnley who showed that the rate decreased as the airborne bacterial load was reduced. The effectiveness was shown in a large Medical Research Council (MRC) trial, but registry data have not shown a consistent benefit. Because we treat patients with rheumatoid arthritis, we decided to look at our theatre air quality. METHODS: In phase 1 we monitored air quality using settle plates, exposed for one hour after the incision, on the instrument trolleys in a joint replacement theatre. In phase 1 the scrub person did not wear a body exhaust system. In phase 2 all three staff used a body exhaust system, and we played close attention to the orientation and position of the surgical lights and trolleys. RESULTS: In phase 1 we grew 0.24 colonies/plate/hour in the ultraclean zone, which is comparable to the Charnley trial findings. In the second phase we grew 0.03 colonies/plate/hour (p<0.001). When plates were placed on the trolleys in controlled positions there was a tendency for the colonies to appear on the corners of the trolleys at the edge of the clean zone (NS). DISCUSSION: The study showed that in phase 1 colony counts comparable to the original Charnley studies were achieved. Colony counts of 0.03 colonies/plate/hour can be achieved in contemporary practice, with all team members using body exhausts.
Authors: A Agodi; F Auxilia; M Barchitta; M L Cristina; D D'Alessandro; I Mura; M Nobile; C Pasquarella Journal: J Hosp Infect Date: 2015-03-27 Impact factor: 3.926
Authors: Arash Aalirezaie; Mustafa Akkaya; C Lowry Barnes; Francisco Bengoa; Murat Bozkurt; Kyle H Cichos; Elie Ghanem; Rabih O Darouiche; Andris Dzerins; Safa Gursoy; Sebastian Illiger; Joseph A Karam; Ianiv Klaber; Georgios Komnos; Christoph Lohmann; Everth Merida; Piret Mitt; Charles Nelson; Nilo Paner; J Manuel Perez-Atanasio; Mike Reed; Marshall Sangster; Daniel Schweitzer; Mehmet Emin Simsek; Brian M Smith; Greg Stocks; Peteris Studers; Darko Talevski; Juliane Teuber; Christopher Travers; Kelly Vince; Matthias Wolf; Koji Yamada; Kelly Vince Journal: J Arthroplasty Date: 2018-10-19 Impact factor: 4.757
Authors: Walter Popp; Christof Alefelder; Sonja Bauer; Georg Daeschlein; Petra Geistberger; Sabine Gleich; Caroline Herr; Nils-Olaf Hübner; Lutz Jatzwauk; Wolfgang Kohnen; Rüdiger Külpmann; Friederike Lemm; Barbara Loczenski; Jörg Spors; Peter Walger; Markus Wehrl; Klaus-Dieter Zastrow; Martin Exner Journal: GMS Hyg Infect Control Date: 2019-12-04